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CC BY-NC-ND 4.0 · Journal of Child Science 2017; 07(01): e142-e145
DOI: 10.1055/s-0037-1607330
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Small Bowel Volvulus due to Mesenteric Lymphatic Malformation: MDCT Demonstration of Counterclockwise Barber Pole Sign

V. Vinay
1   Department of Imaging Services, Narayana Health, Mazumdar Shaw Medical Centre, Bengaluru, India
,
Venkatraman Bhat
1   Department of Imaging Services, Narayana Health, Mazumdar Shaw Medical Centre, Bengaluru, India
,
G. K. Pramod
1   Department of Imaging Services, Narayana Health, Mazumdar Shaw Medical Centre, Bengaluru, India
,
Sanjay Rao
2   Department of Pediatric Surgery, Narayana Health, Mazumdar Shaw Medical Centre, Bengaluru, India
,
Srinivas Ramaiah
3   Department of Pathology, Narayana Health, Mazumdar Shaw Medical Centre, Bengaluru, India
› Author Affiliations
Further Information

Publication History

25 April 2017

16 September 2017

Publication Date:
28 November 2017 (online)

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Abstract

Counterclockwise barber pole sign (also known as reverse barber pole sign) is an angiographic sign described in patients with small bowel volvulus due to counterclockwise twisting of mesenteric vessels around the superior mesenteric artery (SMA). The sign was first described in a catheter angiographic examination; however, the concept can be translated to the display methods of computed tomography (CT). This sign can be depicted clearly on multiplanar and three-dimensionally rendered images of multidetector computed tomography (MDCT) examination. In the current report, the reverse barber pole sign is illustrated in a child with partial small bowel volvulus secondary to mesenteric lymphatic malformation. The clinical course, management, and imaging appearances are presented, highlighting the observation of counterclockwise barber pole sign on MDCT imaging. The importance of the sign in identification of volvulus and implications for patient management are emphasized.

Keywords

mesenteric lymphatic malformation - small bowel volvulus - counter clockwise barber pole sign - CT angiography

Funding

None.


Note

Consent from the guardian for publication was obtained.


 

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