Utility of the CT Scan in Diagnosing Midgut Volvulus in Patients with Chronic Abdominal Pain.

Ehsan Shahverdi,Mehdi Morshedi,Maryam Allahverdi Khani,Mohammad Baradaran Jamili,Fatemeh Shafizadeh Barmi

doi:10.1155/2017/1079192

Abstract

Symptomatic intestinal malrotation first presenting in the adults is rare. Midgut volvulus is the most common complication of malrotation in the adults. Because of more differential diagnosis, Computed Tomography (CT) scan can play an important role in the evaluation of patients with this abnormality. The whirl pattern around the superior mesenteric artery found on CT scan in patients with midgut volvulus is pathognomonic and diagnostic. We describe a case of intestinal malrotation complicated by midgut volvulus in an adult patient. The preoperative CT findings were pathognomonic.

Highlights

A volvulus is a subtype of malrotation, in which a loop of bowel twisted about a focal point along the mesentery attached to the intestinal tract, which may result in a bowel obstruction [1]
Computed Tomography (CT) scan can play a major role in the evaluation of intestinal malrotation
Midgut volvulus should be suspected in every patient presenting with abrupt onset of pain and sign of intestinal obstruction without obvious causes

Summary

Introduction

A volvulus is a subtype of malrotation, in which a loop of bowel twisted about a focal point along the mesentery attached to the intestinal tract, which may result in a bowel obstruction [1]. Midgut volvulus is more frequent in children and young adults but rarely presented in adults. It may be a different obstruction and most importantly compromising blood flow to and from the bowel wall threatening intestinal viability [2, 3]. The peptic ulcer occurs in 20% of patients, probably because the current recession is in the atrium duodenum [2]. Diagnosis of intestinal malrotation in adults rarely occurs. We describe a 52-year-old female with diagnosis of midgut volvulus with chronic abdominal pain and bowel obstruction. The patient was asked to sign an informed consent form. All the terms of the Helsinki Declaration were considered, and the personal information remained anonymous

Case Report

Laboratory Tests and Images

Findings

Discussion

Conclusion