Presentation
Abdominal pain associated with weight loss and anorexia for 3 months.
Patient Data
Evidence clockwise swirling of mesentery and superior mesenteric vein around superior mesenteric artery at the duodenojejunal junction making the so-called whirlpool sign resulting in significant distension of the duodenum, gastric pyloris and stomach.
The duodenojejunal flexure (DJF) is located lower than its normal position showing abrupt narrowing. No bowel dilatation distal to the DJF.
Right renal pelvis fullness is noted probably due to pressure effect caused by distended duodenum.
Case Discussion
The features are suggestive of intestinal malrotation with midgut volvulus (chronic) resulting in significant proximal gastroduodenal distension.