The key findings in this case would be the presence of two transition points that are in close proximity to each other. Given the fact that nearly the entire remnant small bowel is involved, urgent surgical intervention would be advised to preserve what little small bowel remains for this patient. Additionally, the impression of swirling at the transition point suggests an element of volvulus.

The patient proceeded to emergency surgery where a band adhesion at the transition point as demonstrated on CT was released; in addition, the operative note remarked on a volvulus of the small bowel at the adhesion, corresponding with the swirl sign seen on CT. The small bowel was healthy otherwise and the patient did not require any bowel resection. Gut continuity was restored as part of the same operation, and the patient is recovering well some months post-operatively, though with challenging electrolyte balance given the relatively short length of the remaining small bowel.