Sonographic whirlpool sign in neonatal intestinal volvulus
Now open: Certificate Course in Management of Covid-19 by Govt. Of Gujarat and PlexusMDKnow more...Now open: Certificate Course in Management of Covid-19 by Govt. Of Gujarat and PlexusMDKnow more...
Volvulus is potentially life-threatening, and timely surgical correction is crucial. The characteristic whirlpool sign observed in the image, indicating the twisting of the mesentery and superior mesenteric artery and vein, is a diagnostic feature of volvulus. After detecting the whirlpool sign an emergent surgical correction is initiated. However as CT is not always available, delayed diagnosis is common. Moreover, point-of-care sonography is convenient, accessible, and free of radiation exposure. The sonographic whirlpool sign is pathognomonic, sensitive, and a useful indicator of volvulus. Being familiar with the sonographic whirlpool sign facilitates the early diagnosis of volvulus and its timely surgical correction.

A full-term male newborn presented with projectile bilious vomiting 4 days after birth. A physical examination revealed a mild abdominal distension without an obvious peritoneal sign. An abdominal X-ray revealed a mild stomach distension and bowel dilatation over the left lower quadrant area. Laboratory tests revealed nonspecific findings, and a transabdominal sonogram revealed a typical whirlpool sign in the epigastric region, indicating the twisting of the mesentery and superior mesenteric artery and vein.

The patient was diagnosed with malrotation and volvulus, and an emergent operation was immediately performed without computed tomography. Furthermore, a malrotation of 360°–540° with midgut volvulus was observed, and the laparoscopic Ladd procedure was smoothly performed without the resection of the intestine. The newborn started feeding on postoperative day 7 and was discharged 3 days later. One-year follow-up showed that he had an uneventful recovery.

source: https://www.pediatr-neonatol.com/article/S1875-9572(20)30107-8/fulltext
Like
Comment
Share