Abstract

Whirl sign represents the swirling appearance of the mesentery and superior mesenteric vein around the superior mesenteric artery. The direction of swirl is counter clockwise on the CT scan. The patient was consented for an emergent operation and underwent an exploratory laparotomy and Ladds procedure was performed.

We report a case of a 16 -year-old male who presented with acute onset right upper quadrant (RUQ) abdominal pain with investigations demonstrating midgut volvulus due to malrotation causing intestinal obstruction. Although the entity is well described in the literature, diagnosis is often difficult due to its clinical presentation being similar to mesenteric ischemia.

This case report highlights the difficulty in diagnosing midgut volvulus in the adult population given the nonspecific, insidious symptoms therefore prompting awareness of its existence and a high degree of clinical suspicion.

Keywords: abdominal pain, case report, intestinal volvulus, small bowel volvulus, midgut volvulus, small bowel obstruction, whirl/ whirlpool sign.