Purpose or Case Report: To share these uncommon but important cases of Midgut Volvulus (MGV) without malrotation.
Methods & Materials: - 15-day-old Male presented with bilious emesis. An Ultrasound was perfomed.
- 9-year-old Female with History of cerebral palsy, Gastro-jejunostomy tube fed. Presented with abdominal pain and hematemesis. A CT scan was obtained.
Results: - The 15-day-old patient Ultrasound showed: SMA Cut-off as well as Superior mesenteric vein (SMV) Cut-off. In addition, congestion of the mesenteric venous vasculature and a subtle swirling of the bowel around the SMA. The diagnosis of Midgut Volvulus was made. No UGI examination was performed. At Surgery, MGV without malrotation were found.
- The 9-year-old CT showed: SMA Cut-off as well as (SMV) Cut-off. In addition, a subtle swirling/kinking of the bowel around the SMA. The diagnosis of Midgut Volvulus was made. No UGI examination was performed. At Surgery, MGV without malrotation were found in addition to midgut infarction.
Conclusions: These 2 cases illustrate the fact that a typical MGV can occur in the absence of malrotation. Although, no UGI was performed, we speculate that UGI examination to the ligament of Treitz may have been negative in these cases since there was no malrotation at surgery.
SMA cut-off sign was important to make the diagnosis at Ultrasound and CT.