Small bowel volvulus presenting as lower abdominal pain

Lan-Chi Huang, Wen-Han Chang, Weide Tsai, Ding-Kuo Chien


A 38-year-old healthy female presented to emergency department with acute onset of lower abdominal pain. Due to progressive lower abdominal pain after conservative therapy, the patient was investigated using a contrast-enhanced abdominal computed tomography (CT) for cause identification. The CT scan showed a “whirl sign”, a sunshine-like picture that bowel loops and mesentery rotate around a fixed point, and ischemic changes of the small intestine. Thus the patient was diagnosed as a small bowel volvulus (SBV) and operated on immediately. At surgery, a band between uterus and mesentery causing overriding on a loop of terminal ileum with strangulation was found. Fortunately, she subsequently recovered well nine days later.