Abstract
Case PresentationA 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.DiscussionMesenteric 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.
Highlights
Mesenteric volvuli occur when bowel twists around its mesenteric root.[1]. This results in bowel wall and vascular compression, with subsequent intestinal obstruction and ischemia
Mesenteric whirl sign visualized on computed tomography
What do we already know about this clinical entity? Mesenteric volvulus occurs when bowels twists around its mesenteric root and can result in bowel wall and vascular compression, intestinal obstruction and ischemia
Summary
Abdominal Computed Tomography with a Twist: The ‘Whirl Sign’ for Mesenteric Volvulus. University of Washington, School of Medicine, Department of Emergency Medicine, Seattle, Washington. 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
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