472

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Video of the Month Am J Gastroenterol 2014;109:472; doi:10.1038/ajg.2014.14

Whirlpool sign in intestinal volvulus. A 6-year-old boy with cerebral palsy and autism presented to the emergency department with irritability and cyanosis. Abdominal X-ray (top left) revealed coffee bean–shaped dilated bowel loops indicative of intestinal ileus. Computed tomography with vascular imaging (top right) showed twisted bowels, mesentery, and mesenteric vessels—known as the “whirl sign” or “whirlpool sign” (arrow)—suggesting an intestinal volvulus. Laparotomy (bottom) revealed strangulated bowels with a 900° clockwise volvulus. The gangrenous bowels were resected, jejunostomy was performed, and parenteral nutrition was provided. Regular follow-up for short-bowel syndrome was conducted in outpatient clinics. In the video, serial images from computed tomography show the dynamic changes of the whirlpool pattern. (Submitted by Chien-Yu Lin and Hung-Chang Lee, Hsinchu Mackay Memorial Hospital, Hsinchu City, Taiwan.)

To watch the Video of the Month, please visit AJG online: http://www.nature.com/ajg/journal/v109/n4/suppinfo/ajg201414s1.html

The American Journal of Gastroenterology

Volume 109 | april 2014 www.amjgastro.com

Video of the month: whirlpool sign in intestinal volvulus.

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