PMC7338997_01
Axial contrast-enhanced CT images of the upper abdomen. (A) Superior mesenteric artery (black arrow) is abnormally located to the right of the superior mesenteric vein (white arrowhead). (B) Abnormally positioned small bowel around the SMA (black arrow) with a characteristic swirling pattern, consistent with midgut volvulus. (C) Small bowel dilatation (asterisk) secondary to small bowel obstruction due to midgut volvulus.
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It showed right-to-left inversion of superior mesenteric artery (SMA) and vein, as well as swirling intestines, consistent with malrotation and midgut volvulus (Fig. 1).
Laparotomy showing ischemic bowels.
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It revealed bluish discoloration of the small bowels with areas that were significantly dark (Fig. 2).
Rotation of the mesentery over Ladd bands resulting in volvulus.
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The mesentery was twisted, resulting in secondary ischemia (Fig. 3).
Revascularization of the bowel after de-rotating the mesentery by surgical team. Note the dilated veins at the walls of the colon.
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The majority of the bowel resumed Its viable color, peristalsis and had palpable mesenteric pulses (Fig. 4).