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Unusual presentations of midgut volvulus with the whirlpool sign.
J Ultrasound Med. 2006 Jan; 25(1):99-103.JU

Abstract

OBJECTIVE

The purpose of this series was to emphasize the varied presentations of midgut volvulus from neonatal life to well into adulthood and to evaluate the role of the whirlpool sign on sonography in diagnosing this condition.

METHODS

A retrospective search of all midgut volvulus cases diagnosed in the radiology department of a 1500-bed general hospital between February 2002 and July 2005 was done. Eight patients with surgically confirmed midgut volvulus were found, all of whom had undergone sonography as the initial screening investigation.

RESULTS

Eight patients, with ages ranging from 9 days to 32 years (mean age, 11.8 years), had undergone sonography for varied conditions, including bilious and nonbilious vomiting, vague abdominal pain, epigastric lumps, weight loss, features mimicking appendicitis, and pancreatitis. In all patients, the diagnosis of midgut volvulus was made on the basis of the clockwise whirlpool sign on sonography. Subsequently, 4 patients underwent upper gastrointestinal series, and contrast-enhanced computed tomography was done in 6 cases. Surgical confirmation of the diagnosis was obtained in all cases. Two patients were taken for surgery on the basis of only sonographic findings.

CONCLUSIONS

Midgut volvulus can also appear much beyond the neonatal age group with a variety of clinical presentations, making the clinical diagnosis in such patients very difficult, if not impossible. Identification of the clockwise whirlpool sign on sonography is an accurate way of diagnosing this condition, which can preclude the need for further investigations and can allow prompt surgical intervention.

Authors+Show Affiliations

Department of Radiodiagnosis, Government Medical College, Nagpur, India. kishortaori@yahoo.co.inNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16371559

Citation

Taori, Kishor, et al. "Unusual Presentations of Midgut Volvulus With the Whirlpool Sign." Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine, vol. 25, no. 1, 2006, pp. 99-103.
Taori K, Sanyal R, Attarde V, et al. Unusual presentations of midgut volvulus with the whirlpool sign. J Ultrasound Med. 2006;25(1):99-103.
Taori, K., Sanyal, R., Attarde, V., Bhagat, M., Sheorain, V. S., Jawale, R., & Rathod, J. (2006). Unusual presentations of midgut volvulus with the whirlpool sign. Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine, 25(1), 99-103.
Taori K, et al. Unusual Presentations of Midgut Volvulus With the Whirlpool Sign. J Ultrasound Med. 2006;25(1):99-103. PubMed PMID: 16371559.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Unusual presentations of midgut volvulus with the whirlpool sign. AU - Taori,Kishor, AU - Sanyal,Rupan, AU - Attarde,Vinod, AU - Bhagat,Manish, AU - Sheorain,Virender Singh, AU - Jawale,Rajesh, AU - Rathod,Jawahar, PY - 2005/12/24/pubmed PY - 2006/5/5/medline PY - 2005/12/24/entrez SP - 99 EP - 103 JF - Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine JO - J Ultrasound Med VL - 25 IS - 1 N2 - OBJECTIVE: The purpose of this series was to emphasize the varied presentations of midgut volvulus from neonatal life to well into adulthood and to evaluate the role of the whirlpool sign on sonography in diagnosing this condition. METHODS: A retrospective search of all midgut volvulus cases diagnosed in the radiology department of a 1500-bed general hospital between February 2002 and July 2005 was done. Eight patients with surgically confirmed midgut volvulus were found, all of whom had undergone sonography as the initial screening investigation. RESULTS: Eight patients, with ages ranging from 9 days to 32 years (mean age, 11.8 years), had undergone sonography for varied conditions, including bilious and nonbilious vomiting, vague abdominal pain, epigastric lumps, weight loss, features mimicking appendicitis, and pancreatitis. In all patients, the diagnosis of midgut volvulus was made on the basis of the clockwise whirlpool sign on sonography. Subsequently, 4 patients underwent upper gastrointestinal series, and contrast-enhanced computed tomography was done in 6 cases. Surgical confirmation of the diagnosis was obtained in all cases. Two patients were taken for surgery on the basis of only sonographic findings. CONCLUSIONS: Midgut volvulus can also appear much beyond the neonatal age group with a variety of clinical presentations, making the clinical diagnosis in such patients very difficult, if not impossible. Identification of the clockwise whirlpool sign on sonography is an accurate way of diagnosing this condition, which can preclude the need for further investigations and can allow prompt surgical intervention. SN - 0278-4297 UR - https://www.unboundmedicine.com/medline/citation/16371559/Unusual_presentations_of_midgut_volvulus_with_the_whirlpool_sign_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0278-4297&date=2006&volume=25&issue=1&spage=99 DB - PRIME DP - Unbound Medicine ER -