Abdominal Computed Tomography with a Twist: The 'Whirl Sign' for Mesenteric Volvulus

腹部计算机断层扫描新发现:肠系膜扭转的“漩涡征”

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Abstract

CASE PRESENTATION: A 55-year-old woman with a history of end-stage renal disease, peripheral vascular disease, and multiple prior abdominal surgeries presented to the emergency department with three days of diffuse, severe, abdominal pain with accompanying nausea, emesis, and food intolerance. A computed tomography (CT) of her abdomen demonstrated a "whirl" of small bowel and mesenteric vessels, raising suspicion for mesenteric volvulus and resultant small bowel obstruction. DISCUSSION: Mesenteric volvulus is a low incidence, high mortality condition; therefore, early recognition and operative intervention are critical. Patients with a "whirl sign" on CT are more likely to require surgical intervention for their small bowel obstruction.

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