Target sign of intussusception versus whirlpool sign of midgut volvulus

AbstractMesentery is an uncommon location for occurrence of lymphatic malformations. Lymphatic malformations causing midgut volvulus are described in pediatric population; however, it is a rare presentation in adults. We present case of 20-year-old man with a large mesenteric lymphatic malformation who presented with acute abdominal complaints. On radiological work up, the lymphatic malformation was seen causing midgut volvulus and closed loop small bowel obstruction with the presence of classical whirlpool sign. The patient underwent emergency surgery and the lymphatic malformation was completely excised along with resection of a segment of small bowel loop.

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Malrotation and Midgut Volvulus associated with Asymptomatic Duplication Cyst of Jejunum

APSP Journal of Case Reports ◽

10.21699/ajcr.v7i4.447 ◽

2016 ◽

Vol 7 (4) ◽

pp. 33 ◽

Cited By ~ 3

Author(s):

Sandip Kumar Rahul ◽

Vijai Datta Upadhyaya ◽

Basant Kumar

Keyword(s):

Abdominal Pain ◽

Alimentary Tract ◽

Duplication Cyst ◽

Midgut Volvulus ◽

Whirlpool Sign ◽

Mesenteric Vessels ◽

Relationship Of ◽

Variable Presentation

Gastrointestinal duplications can affect any part of the alimentary tract and are notorious for their variable presentation. Their association with malrotation and midgut volvulus is rare. We describe an 8-year old boy presented with episodes of abdominal pain. Radiological workup showed whirlpool sign and abnormal relationship of mesenteric vessels. At operation, malrotation with chronic volvulus were found. Incidentally, a jejunal communicating duplication cyst was also noted.

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Intestinal malrotation with solitary jejunal diverticulum presenting as midgut volvulus in an adult: an unusual presentation

International Surgery Journal ◽

10.18203/2349-2902.isj20212745 ◽

2021 ◽

Vol 8 (7) ◽

pp. 2231

Author(s):

Debarghya Chatterjee ◽

Subrat Kumar Raul ◽

Elisheba Patras

Keyword(s):

Abdominal Pain ◽

Superior Mesenteric Artery ◽

Mesenteric Artery ◽

Intestinal Malrotation ◽

Midgut Volvulus ◽

Rare Entity ◽

Intermittent Abdominal Pain ◽

Post Operative Period ◽

Jejunal Diverticulum ◽

Whirlpool Sign

Intestinal malrotation with midgut volvulus presenting in adults is a rare entity, and association with jejunal diverticulum is rarer still. Herein, we report and review such a case of malrotation and volvulus, associated with intestinal band adhesions and a solitary jejunal diverticulum. This 67 years old gentleman had presented with complaints of intermittent abdominal pain for past several years. Imaging of the abdomen revealed twisting of superior mesenteric artery and vein, evidence of midgut volvulus and intestinal malrotation with “whirlpool sign”. Laparotomy revealed a midgut volvulus, extensive adhesions involving the root of the mesentery and a jejunal diverticulum. Adhesiolysis was performed, untwisting of the bowel was done and the jejunal diverticulum was resected. Post-operative period was uneventful. This case is being reported on account of its extreme rarity.

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Portal venous gas in intestinal malrotation with mild midgut volvulus

Surgical Case Reports ◽

10.1186/s40792-019-0700-z ◽

2019 ◽

Vol 5 (1) ◽

Author(s):

Ryuichiro Hirose ◽

Hiroki Kai ◽

Kaori Inatomi ◽

Tsuyoshi Iwanaka ◽

Naomi Morishima ◽

...

Keyword(s):

Gas Bubbles ◽

Acute Onset ◽

Intestinal Malrotation ◽

Midgut Volvulus ◽

Portal Venous Gas ◽

Ischemic Change ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Whirlpool Sign ◽

Operative Findings

Abstract Background Portal venous gas has been considered as a radiological sign requiring urgent operative intervention; however, the reports concerning portal venous gas associated with favorable outcome are recently increasing. Case presentation We describe a 9-month-old boy with acute onset high fever and vomiting. The ultrasonography demonstrated micro-gas bubbles continuously floating in the intrahepatic portal vein. Contrast-enhanced CT, performed 1 h later from echography, revealed a whirlpool sign suggesting an intestinal malrotation with midgut volvulus, but with no signs of residual intrahepatic gas. Operative findings showed a mild volvulus with neither congestion nor ischemic change of the twisted bowel. Detorsion and Ladd’s procedure were completed laparoscopically. Conclusions Transient portal venous gas bubbles may be generated even in the mild intestinal volvulus with no bowel ischemia. Ultrasonography can be a sensitive detector to visualize such small amounts of gas.

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