{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,9,16]],"date-time":"2024-09-16T16:45:55Z","timestamp":1726505155981},"reference-count":6,"publisher":"California Digital Library (CDL)","issue":"4","license":[{"start":{"date-parts":[[2021,10,28]],"date-time":"2021-10-28T00:00:00Z","timestamp":1635379200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Introduction: Adult intestinal malrotation with midgut volvulus is rare and most often diagnosed on abdominal imaging. Once the diagnosis is made, prompt surgical intervention is necessary. A finding suggestive of malrotation with midgut volvulus on abdominal imaging is the \u201cwhirlpool\u201d sign where the superior mesenteric vein and superior mesenteric artery twist at the root of the abdominal mesentery. This sign was once thought to be pathognomonic, but recent studies have shown that it can be seen in asymptomatic patients. \nCase Report: A 20-year-old female presented to our emergency department with diffuse abdominal pain. Computed tomography demonstrated the \u201cwhirlpool\u201d sign with a concern for malrotation with midgut volvulus. Surgical consultation was obtained and the patient was rushed to the operating room for an exploratory laparotomy. Normal mesenteric attachments were seen and no significant pathology was identified during the laparotomy. The patient was eventually diagnosed with gastritis and discharged in stable condition.  \nConclusion: Emergency physicians and surgeons alike should be cautious in confirming malrotation with midgut volvulus solely due to the \u201cwhirlpool\u201d sign on abdominal imaging. Premature diagnostic closure can lead to unnecessary procedures and interventions for patients as in the case we report here.<\/jats:p>","DOI":"10.5811\/cpcem.2021.9.52682","type":"journal-article","created":{"date-parts":[[2021,11,19]],"date-time":"2021-11-19T22:58:31Z","timestamp":1637362711000},"page":"463-465","source":"Crossref","is-referenced-by-count":0,"title":["Whirlpool No More: A Case of Misdiagnosed Malrotation with Midgut Volvulus"],"prefix":"10.5811","volume":"5","author":[{"given":"Michael","family":"Fogam","sequence":"first","affiliation":[{"name":"Mount Sinai St. Luke\u2019s and Mount Sinai West, Department of Emergency Medicine, New York, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natasha","family":"Leigh","sequence":"additional","affiliation":[{"name":"Mount Sinai St. Luke\u2019s and Mount Sinai West, Department of Surgery, New York, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Trent","family":"She","sequence":"additional","affiliation":[{"name":"Mount Sinai St. Luke\u2019s and Mount Sinai West, Department of Emergency Medicine, New York, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"29705","published-online":{"date-parts":[[2021,10,28]]},"reference":[{"key":"ref0","doi-asserted-by":"publisher","unstructured":"Butterworth W and Butterworth J. An adult presentation of midgut volvulus secondary to intestinal malrotation: A case report and literature review.\u00a0Int J Surg Case Rep. 2018;50:46-9.","DOI":"10.1016\/j.ijscr.2018.07.007"},{"key":"ref1","doi-asserted-by":"crossref","unstructured":"Stueland D. The acute presentation of intestinal nonrotation.\u00a0Am J Emerg Med. 1989;7(2):235-7.","DOI":"10.1016\/0735-6757(89)90144-7"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"Tayde P, Wanjari A, Deshmukh A, et al. Midgut malrotation with chronic abdominal pain.\u00a0N Am J Med Sci. 2012;4(4):196-8.","DOI":"10.4103\/1947-2714.94950"},{"key":"ref3","doi-asserted-by":"publisher","unstructured":"Taylor G. CT appearance of the duodenum and mesenteric vessels in children with normal and abnormal bowel rotation.\u00a0Pediatr Radiol. 2011;41(11):1378-83.","DOI":"10.1007\/s00247-011-2118-z"},{"key":"ref4","doi-asserted-by":"publisher","unstructured":"Sodhi K, Bhatia A, Saxena A, et al. Anticlockwise swirl of mesenteric vessels: a normal CT appearance, retrospective analysis of 200 pediatric patients.\u00a0Eur J Radiol. 2014;83(4):710-4.","DOI":"10.1016\/j.ejrad.2013.12.026"},{"key":"ref5","doi-asserted-by":"publisher","unstructured":"Blake M and Mendelson R. The whirl sign: a non-specific finding of mesenteric rotation.\u00a0Australas Radiol. 1996;40(2):136-9.","DOI":"10.1111\/j.1440-1673.1996.tb00367.x"}],"container-title":["Clinical Practice and Cases in Emergency Medicine"],"original-title":[],"deposited":{"date-parts":[[2021,11,19]],"date-time":"2021-11-19T22:58:37Z","timestamp":1637362717000},"score":1,"resource":{"primary":{"URL":"https:\/\/escholarship.org\/uc\/item\/2z8583tc"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,28]]},"references-count":6,"issue-title":["Clinical Practice and Cases in Emergency Medicine"],"journal-issue":{"issue":"4","published-online":{"date-parts":[[2021,11,10]]}},"URL":"https:\/\/doi.org\/10.5811\/cpcem.2021.9.52682","relation":{},"ISSN":["2474-252X","2474-252X"],"issn-type":[{"type":"electronic","value":"2474-252X"},{"type":"print","value":"2474-252X"}],"subject":[],"published":{"date-parts":[[2021,10,28]]}}}