Yeh W C, Wang H P, Chen C, Wang H H, Wu M S, Lin J T
Department of Internal Medicine, En Chu Kong Hospital, Taipei Hsien, Taiwan.
J Clin Ultrasound. 1999 Jun;27(5):279-83. doi: 10.1002/(sici)1097-0096(199906)27:5<279::aid-jcu8>3.0.co;2-g.
Midgut malrotation and volvulus, found mostly in children, are rare and difficult to diagnose preoperatively in adults. We report 2 cases in which a 68-year-old man and a 75-year-old woman presented with intermittent cramping abdominal pain, abdominal distention, and vomiting. Abdominal sonography demonstrated wrapping of the superior mesenteric vein and bowel loops around the superior mesenteric artery (the "whirlpool sign") in both patients. Abdominal CT revealed similar findings. The diagnoses of midgut volvulus and mesenteric malrotation were made, and the patients underwent laparotomy. The man was confirmed to have duodenojejunal malrotation and volvulus, and the woman had cecal volvulus. The whirlpool sign is valuable for the preoperative diagnosis of mesenteric vessel malrotation and midgut volvulus.
中肠旋转不良和肠扭转多见于儿童，在成人中较为罕见且术前难以诊断。我们报告2例病例，一名68岁男性和一名75岁女性表现为间歇性腹部绞痛、腹胀和呕吐。腹部超声显示两名患者的肠系膜上静脉和肠袢围绕肠系膜上动脉呈螺旋状（“漩涡征”）。腹部CT显示了类似的结果。诊断为中肠扭转和肠系膜旋转不良，两名患者均接受了剖腹手术。该男性被确诊为十二指肠空肠旋转不良和肠扭转，而该女性患有盲肠扭转。漩涡征对肠系膜血管旋转不良和中肠扭转的术前诊断具有重要价值。
