PMC6531863_01
A. Showing twist of the caecum, ascending colon and hepatic flexure in a counter-clockwise direction. B shows the detorted bowel with thickened, narrow mesenteric base. C. showing the grossly dilated caecum, ascending colon and hepatic flexure in their detorted, in vivo configuration. They are sufficiently mobile that they may be lifted out of the abdomen. All of these intestinal segments were not fixed by peritoneum.
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PMC6531863_01_gr1.jpg
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An axial 360  counter-clockwise volvulus of the midgut from terminal ileum to mid transverse colon was encountered around a very narrow mesenteric base (Fig. 1). There was gangrene of the involved intestinal segments which appeared to be grossly distended and the hepatic flexure was noted to be unfixed and mobile (Fig. 1c).