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Midgut volvulus in an adult
1Department of Medical Imaging, John hunter Hospital, New South Wales, Australia. mpuvaneswary@hunter.health.nsw.gov.au
Australasian Radiology
|February 13, 2003
Summary
Adult duodenal malrotation can cause midgut volvulus. Imaging signs like the "whirlpool sign" on ultrasound and CT scans are diagnostic for this serious condition.
Area of Science:
- Gastroenterology
- Radiology
- Surgical Anatomy
Background:
- Duodenal malrotation is a congenital anomaly where the intestines fail to properly rotate during fetal development.
- While often diagnosed in infancy, malrotation can present in adulthood, frequently as a surgical emergency like midgut volvulus.
Observation:
- A case of duodenal malrotation presenting in adulthood with symptoms of midgut volvulus is described.
- Diagnostic imaging utilized included colour Doppler ultrasound and computed tomography (CT).
Findings:
- Colour Doppler ultrasound revealed a characteristic "whirlpool sign," indicating a clockwise rotation of the superior mesenteric vein (SMV) around the superior mesenteric artery (SMA).
- CT imaging demonstrated a distinct "whirl" pattern, with bowel loops encircling the SMA, confirming the diagnosis of midgut volvulus.
Implications:
- Early recognition of these specific imaging findings is crucial for timely diagnosis and surgical intervention in adult patients with malrotation.
- This case highlights the importance of considering congenital anomalies in the differential diagnosis of acute abdominal conditions in adults.