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Updated: Jun 24, 2025

Multimodality Diagnosis of Mesenteric Ischemia
Published on: July 21, 2023
Acute Abdominal Pain and a Whirlpool Sign on Computed Tomography: A Case Report
Christopher Libby1, Evan Stern2,3, Robyn Hoelle2,3
1Cedars Sinai Health System, Department of Emergency Medicine, Los Angeles, California.
Mesenteric volvulus, a rare cause of bowel obstruction in adults, presents with non-specific symptoms. Early identification of the whirlpool sign on CT scans is crucial for timely surgical intervention and improved patient outcomes.
Area of Science:
- Gastroenterology
- Abdominal Surgery
- Radiology
Background:
- Mesenteric volvulus is an uncommon cause of abdominal pain and small bowel obstruction, particularly in elderly patients.
- Non-specific symptoms in adult mesenteric volvulus cases often lead to diagnostic delays.
Purpose of the Study:
- To report a case of adult mesenteric volvulus presenting with non-specific abdominal pain.
- To highlight the diagnostic utility of the whirlpool sign in computed tomography (CT).
Main Methods:
- Case presentation of a 75-year-old female with non-specific abdominal pain.
- Diagnosis of mesenteric volvulus and small bowel obstruction confirmed by CT scan revealing the whirlpool sign.
- Surgical management involving small bowel resection.
Main Results:
- The whirlpool sign on CT accurately identified mesenteric volvulus as the cause of obstruction.
- The patient underwent successful surgical resection and recovered.
- The patient was discharged home in good condition.
Conclusions:
- Early recognition of the whirlpool sign on imaging is critical for diagnosing mesenteric volvulus.
- Prompt surgical consultation and intervention are essential for salvaging ischemic small bowel and preventing mortality.
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