Abstract
Midgut volvulus is a cause of acute abdomen in neonates and infants. Learning to recognize the US ?ndings of midgut volvulus is imperative, and it should always be considered in the differential diagnosis of abdominal pain in the pediatric population. For the neonate with the classic appearance of a whirlpool sign, additional imaging investigation is often unnecessary, and the surgeon should be alerted to plan for emergency surgery. Until now, the diagnosis of this condition has relied on upper gastrointestinal barium studies. We describe a case of midgut volvulus diagnosed on ultrasound after observing the whirlpool sign. This sign corresponds to a clockwise wrapping of the superior mesenteric vein and the mesentery around the superior mesenteric artery. Using ultrasound as an investigation modality when suspecting midgut volvulus in neonates and infants is also emphasized. Also, the advantages of US for this age group are apparent, since it can be performed at the bedside in intensive care units and lacks the adverse effects of ionizing radiation.
Highlights
Midgut volvulus is a cause of acute abdomen in neonates and infants
Learning to recognize the US findings of midgut volvulus is imperative, and it should always be considered in the differential diagnosis of abdominal pain in the pediatric population
For the neonate with the classic appearance of a whirlpool sign, additional imaging investigation is often unnecessary, and the surgeon should be alerted to plan for emergency surgery
Summary
Midgut volvulus is a cause of acute abdomen in neonates and infants. Learning to recognize the US findings of midgut volvulus is imperative, and it should always be considered in the differential diagnosis of abdominal pain in the pediatric population. For the neonate with the classic appearance of a whirlpool sign, additional imaging investigation is often unnecessary, and the surgeon should be alerted to plan for emergency surgery. The diagnosis of this condition has relied on upper gastrointestinal barium studies
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