malrotation with midgut volvulus
Life-threatening surgical emergency where abnormal intestinal rotation allows the small bowel to twist around the superior mesenteric artery, causing bowel ischemia.
Full Definition
A devastating complication of intestinal malrotation where the abnormally positioned and mobile small bowel rotates around the narrow-based superior mesenteric artery, leading to acute vascular compromise and bowel ischemia. Malrotation results from incomplete embryologic rotation of the midgut, leaving the cecum and duodenojejunal junction abnormally positioned with a narrow mesenteric base. Clinical presentation is often acute with bilious vomiting, and imaging findings include the classic "whirlpool sign" on CT or ultrasound, representing the twisted bowel and mesenteric vessels. This condition requires emergency surgical intervention (Ladd procedure) to prevent massive bowel necrosis and death.
Usage
Usage note: This is a surgical emergency; malrotation alone is less urgent than when complicated by volvulus and ischemia.
In Context
- "Emergency CT demonstrated the whirlpool sign pathognomonic for malrotation with midgut volvulus, prompting immediate surgical consultation." — Emergency pediatric radiology report
- "Upper GI series showed abnormal position of the duodenojejunal junction, raising concern for malrotation with potential for midgut volvulus." — Pediatric GI imaging study