Midgut volvulus induced extensive bowel infarction

Area of Science:

• Gastroenterology
• Surgical Emergency
• Abdominal Imaging

Background:

• Midgut volvulus is a rare but life-threatening complication, often stemming from congenital midgut malrotation.
• It can also arise from acquired conditions including postoperative adhesions, tumors, and mesenteric cysts.
• This condition leads to bowel ischemia due to superior mesenteric artery torsion, necessitating urgent intervention.

Purpose of the Study:

• To report a case of midgut volvulus presenting with characteristic computed tomography (CT) findings.
• To highlight the importance of early diagnosis and surgical intervention in preventing extensive bowel necrosis.

Main Methods:

• Case report of a patient with midgut volvulus.
• Utilized computed tomography (CT) for diagnosis, identifying key features such as the whirl sign and transposition of the superior mesenteric artery and vein.
• Performed early surgical intervention.

Main Results:

• The CT scan revealed the characteristic whirl sign, indicating torsion of the superior mesenteric artery.
• Transposition of the superior mesenteric artery and vein was observed.
• Early surgical intervention successfully prevented extensive bowel resection and necrosis.

Conclusions:

• Midgut volvulus, even when acquired, is a surgical emergency requiring prompt diagnosis.
• Characteristic CT findings, including the whirl sign, are vital for early identification.
• Timely surgical management is critical to avoid catastrophic outcomes such as extensive bowel resection.