Unusual Presentations of Midgut Volvulus With the Whirlpool Sign

Taori, Kishor; Sanyal, Rupan; Attarde, Vinod Yadav; Mp, Bhagat; Sheorain, Virender; Jawale, Rajesh; Rathod, Jawahar

doi:10.7863/jum.2006.25.1.99

Cited by 16 publications

(20 citation statements)

References 11 publications

(8 reference statements)

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“…Additionally, among 3 patients with a counterclockwise whirlpool sign, none had intestinal volvulus during laparotomy, again emphasizing the importance of the direction of rotation. In another report, Taori and coworkers 20 showed that in 8 cases of volvulus, the whirlpool sign was shown in all of them, indicating sensitivity of 100%. All cases had a clockwise direction.…”

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confidence: 91%

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Prenatal Diagnosis of Small-Bowel Volvulus Using 3-Dimensional Doppler Sonography

Sammour

Leibovitz

Degani

et al. 2008

Journal of Ultrasound in Medicine

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olvulus is generally a condition that occurs in the pediatric age group, commonly associated with intestinal malrotation. The intrauterine occurrence of this condition is a rare occasion, and only a few cases have been reported. Precise diagnosis is hampered by the extensive differential diagnoses of fetal intra-abdominal masses observed during sonographic examination. However, detection of the "whirlpool sign" facilitates sonographic diagnosis of this condition. We report a case of intestinal volvulus that occurred in utero diagnosed definitively with 2-dimensional and 3-dimensional (3D) Doppler sonography. To our knowledge, there is no previous report of such a case that was diagnosed by 3D Doppler sonography in the English literature. Case ReportA 50-year-old nulliparous woman was admitted to our maternity ward at 28 gestational weeks after decreased fetal movements. Her pregnancy was achieved with ovum donation and in vitro fertilization. She had 1 previous pregnancy that ended with a spontaneous miscarriage. Her medical history was unremarkable. Her routine follow-up results were normal during this pregnancy, including a fetal anatomic scan that was performed 3 weeks earlier.Initial evaluation revealed a nonstress test result of a reassuring fetal heart rate pattern and no uterine contractions. On fetal sonography, a singleton fetus was observed with a normal amniotic fluid index and no ascites or intraperitoneal echogenicity. However, a dilated stomach was seen, together with a fixed, dilated, Cshaped bowel loop in the upper part of the abdominal cavity (Figure 1). The affected bowel had a thick echogenic

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confidence: 91%

“…This sign was described in infants by Pracros and coworkers, 19 who found it in 15 of 18 infants with small-bowel volvulus, indicating high sensitivity. Since then, several reports have shown its accuracy in diagnosing volvulus in infants, [20][21][22][23][24] thus establishing its diagnostic efficacy.…”

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confidence: 99%

Prenatal Diagnosis of Small-Bowel Volvulus Using 3-Dimensional Doppler Sonography

Sammour

Leibovitz

Degani

et al. 2008

Journal of Ultrasound in Medicine

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“…[9] It is also reported that US is very useful in the evaluation of gastrointestinal obstruction and can suggest the diagnosis in atypical clinical presentation of midgut volvulus. [10][11][12] The CT scan does not usually represent the initial diagnostic tool in children with small-bowel obstruction, although it can be used in patients with a long-standing obstruction and marked bowel distension and may be helpful to confirm an SBI after ultrasonographic evidence. [1,12] In our case, US was unable to identify the characteristic signs of intussusception, showing only marked bowel distension and a mass in the mesogastrium.…”

Section: Discussionmentioning

confidence: 99%

A rare complication of small bowel intussusception: Report of a case and review of literature

Impellizzeri¹,

Astra²,

Simona³

et al. 2013

Afr J Paediatr Surg

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Volvulus and intussusception are rare conditions in children. We describe an unusual case of intussusception due to a solitary Peutz-Jeghers type hamartomatous polyp complicated by volvulus, which occurred in an 11-year-old girl. A laparotomy allows to successfully treat the pathology. The postoperative course was favourable. We discuss the clinical findings and the values of the preoperative instrumental diagnosis. The literature is reviewed. Identifying a midgut volvulus, as complication of a small bowel intussusception, during the diagnostic phase could help in choosing the most appropriate surgical approach.

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“…Midgut volvulus can also appear beyond the neonatal period and with a variety of clinical presentations, making the clinical diagnosis in such patients very difficult. Ultrasonography can correctly suggest the diagnosis in such atypical clinical presentations of midgut volvulus [9] (Fig. 6).…”

Section: Midgut Volvulusmentioning

confidence: 97%

Sonographic evaluation of gastrointestinal obstruction in infants: a pictorial essay

Maheshwari

Abograra

Shamam

2009

Journal of Pediatric Surgery

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Unusual Presentations of Midgut Volvulus With the Whirlpool Sign

Cited by 16 publications

References 11 publications

Prenatal Diagnosis of Small-Bowel Volvulus Using 3-Dimensional Doppler Sonography

Prenatal Diagnosis of Small-Bowel Volvulus Using 3-Dimensional Doppler Sonography

A rare complication of small bowel intussusception: Report of a case and review of literature

Sonographic evaluation of gastrointestinal obstruction in infants: a pictorial essay

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