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. 2024 May;8(2):99-101.
doi: 10.5811/cpcem.1394.

Acute Abdominal Pain and a Whirlpool Sign on Computed Tomography: A Case Report

Christopher Libby  1 , Evan Stern  2   3 , Robyn Hoelle  2   3
Affiliations

Acute Abdominal Pain and a Whirlpool Sign on Computed Tomography: A Case Report

Christopher Libby et al. Clin Pract Cases Emerg Med. 2024 May.

Abstract

Introduction: Mesenteric volvulus is a rare cause of abdominal pain and bowel obstruction in elderly patients. When a mesenteric volvulus occurs in adult patients, the symptoms are often non-specific, which contributes to delays in diagnosis.

Case report: We present a case of a 75-year-old female who presented with non-specific abdominal pain. The rare whirlpool sign on computed tomography identified a mesenteric volvulus as the cause of small bowel obstruction. She was taken to the operating room and, after successful resection of the small bowel, she recovered and ultimately was discharged home.

Conclusion: Early identification of a whirlpool sign and early surgical consultation are key to providing the best chance for salvage of ischemic small bowel due to mesenteric volvulus and to prevent a fatal outcome.

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Conflict of interest statement

Conflicts of Interest: By the CPC-EM article submission agreement, all authors are required to disclose all affiliations, funding sources and financial or management relationships that could be perceived as potential sources of bias. This research was supported (in whole or in part) by HCA Healthcare and/or an HCA Healthcare affiliated entity. The views expressed in this publication represent those of the author(s) and do not necessarily represent the official views of HCA Healthcare or any of its affiliated entities.

Figures

Image.
Image.
Computed tomography abdomen with intravenous contrast demonstrating dilated, fluid-filled loops of small bowel and a pattern of swirling mesenteric vessels called the whirlpool sign (arrow).
See this image and copyright information in PMC

References

    1. Fischer JE, Bland KI. Mastery of Surgery. 6th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2012.
    1. Singh S, Das A, Chawla AS, et al. . A rare presentation of midgut malrotation as an acute intestinal obstruction in an adult: two case reports and literature review. Int J Surg Case Rep. 2013;4(1):72–5. - PMC - PubMed
    1. Emanuwa OF, Ayantunde AA, Davies TW. Midgut malrotation first presenting as acute bowel obstruction in adults: a case report and literature review. World J Emerg Surg. 2011;6(1):22. - PMC - PubMed
    1. Durkin ET, Lund D, Shaaban A, et al. . Age-related differences in diagnosis and morbidity of intestinal malrotation. J Am Coll Surg. 2008;206(4):658–63. - PubMed
    1. Butterworth WA, Butterworth JW. An adult presentation of midgut volvulus secondary to intestinal malrotation: a case report and literature review. Int J Surg Case Rep. 2018;50:46–9. - PMC - PubMed