Approximately 50% of these patients have midgut volvulus
at the time of diagnosis.
The pancreatic duct was also found to be prominent (not shown) and this was thought to be secondary to obstruction from the midgut volvulus
Malrotation is most commonly seen in neonates (birth to first 28 days of life) and is another surgical emergency, as the mortality from midgut volvulus
has been shown to be as high as up to 28%.
Maternal death caused by midgut volvulus
after bariatric surgery.
CT scan findings of malrotation with midgut volvulus
may be characteristic.
The obstruction may have been due to adhesions, a chronic midgut volvulus
, or a paraduodenal hernia (Dis.
With midgut volvulus
, the SMV may occupy a position directly anterior or to the left of the SMA.
malrotation with midgut volvulus
, Hirschsprung's disease, meconium ileus or bowel atresia) and inflammatory causes such as gastric or duodenal ulcers.
18-24) The "whirlpool sign" can be seen on both CT and ultrasound in cases of malrotation complicated by midgut volvulus
and describes the twisting of the small bowel and SMV around the SMA.
The extrinsic etiologies include a preduodenal portal vein, malrotation of the gut with a midgut volvulus
or by Ladd bands, or an annular pancreas.
Differential diagnosis of this sign, detected either prenatally or postnatally, includes duodenal atresia, annular pancreas, duodenal stenosis, duodenal webs, and midgut volvulus
Deviation from this developmental pathway may result in a narrow mesenteric attachment, predisposing the patient to midgut volvulus
and bowel ischemia or necrosis.