Sonographic whirlpool sign in neonatal intestinal volvulus

Abstract

A full-term male newborn presented with projectile bilious vomiting 4 days after birth. A physical examination revealed a mild abdominal distension without an obvious peritoneal sign. An abdominal X-ray revealed a mild stomach distension and bowel dilatation over the left lower quadrant area (Supplementary Fig. 1). Laboratory tests revealed nonspecific findings, and a transabdominal sonogram revealed a typical whirlpool sign in the epigastric region, indicating the twisting of the mesentery and superior mesenteric artery and vein (Fig. 1, Video). The patient was diagnosed with malrotation and volvulus, and an emergent operation was immediately performed without computed tomography. Furthermore, a malrotation of 360 e540 with midgut volvulus was observed, and the laparoscopic Ladd procedure was smoothly performed without the resection of the intestine. The newborn started feeding on postoperative day