Small Bowel Volvulus due to Mesenteric Lymphatic Malformation: MDCT Demonstration of Counterclockwise Barber Pole Sign
25. April 2017
16. September 2017
28. November 2017 (online)
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.
Keywordsmesenteric lymphatic malformation - small bowel volvulus - counter clockwise barber pole sign - CT angiography
Consent from the guardian for publication was obtained.
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