Ultrasound “whirlpool sign” of small bowel volvulus

Small bowel volvulus is a real surgical emergency. Early diagnosis and prompt operation are essential to prevent gangrene in the small intestine, which is associated with high morbidity and mortality. This is a life-threatening complication of intestinal malrotations, which is defined by abnormal twisting of a loop of small bowel around the axis of its own mesentery during embryologic development [1]. Clinical signs are represented by the high neonatal obstruction syndrome. Imaging has an essential role in diagnosis. Abdominal X-Ray shows marked distension of the intestines concerning for acute obstruction, however it can further lead to missed or delayed diagnoses. The associated abdominal Doppler ultrasound confirm the diagnosis of volvulus by showing “whirlpool sign”. This sign corresponds to a clockwise wrapping of the superior mesenteric vein and the mesentery around the superior mesenteric artery.