J Korean Radiol Soc.  2004 May;50(5):365-368. 10.3348/jkrs.2004.50.5.365.

Imaging Findings of Midgut Volvulus Associated with a Large Small-Bowel Diverticulum in an Adult Patient: Case Report

• Kim JY
• Rha SE
• Oh SN
• Hwang-bo S
• Byun JY

• KMID: 1593967
• DOI: http://doi.org/10.3348/jkrs.2004.50.5.365

Abstract

Although most patients with jejunoileal diverticulum are asymptomatic, a large, small-bowel diverticulum can be associated with midgut volvulus in an adult. We present a rare case of midgut volvulus that was associated with a large, small-bowel diverticulum in a 77-year-old woman presenting with chronic recurrent abdominal pain. The CT showed the characteristic whirl sign of twisted mesentery, the small bowel loops along the superior mesenteric artery and a large sac-like small-bowel diverticulum. A small bowel series also demonstrated a corkscrew appearance of proximal jejunum, a finding suggestive of midgut volvulus, and a large jejunal diverticulum. During the laparotomy, the small bowel was seen twisted counterclockwise 270 degree. The mesenteric root was very shortened. A 4 cm sized diverticulum was seen on the mesenteric border of jejunum, on the portion about 40 cm distal from the Treitz ligament.

Keyword

Intestines, CT; Intestines, diverticula; Intestines, stenosis or obstruction

MeSH Terms

Abdominal Pain
Adult*
Aged
Diverticulum*
Female
Humans
Intestinal Volvulus*
Jejunum
Laparotomy
Ligaments
Mesenteric Artery, Superior
Mesentery