The markedly dilated caecum is located in the right upper abdominal quadrant. Its transverse diameter is more than 10 cm in its widest portion. It shows air-fluid level, thickened walls & stranding densities in the surrounding mesentery. There is twisting of the medial side of mesenteric fat & vessels resulting to a tornado-like appearance (whirl sign). Dilated fluid-filled small bowel loops are seen. The rest of the colon are collapsed. The duodenum is collapsed and failed to cross the midline. There is an abnormal orientation of the SMA & SMV suggesting malrotation.