Ultrasound “Whirlpool Sign” for Midgut Volvulus

Abstract

Midgut volvulus is a cause of acute abdomen in neonates and infants. It results when the normal embryologic sequence of bowel development and fixation is interrupted. 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.