DOI: https://doi.org/10.36347/sjmcr.2025.v13i10.088

Pages: 2555-2559

Midgut malrotation is a rare congenital anomaly that predisposes to life-threatening complications such as midgut volvulus, especially in neonates. This condition results from incomplete rotation of the primitive intestinal loop, leading to a narrow mesenteric root and a high risk of bowel torsion. We report two cases of term neonates who presented with bilious vomiting in the absence of abdominal distension. In both cases, abdominal radiographs were inconclusive, but ultrasound with color Doppler revealed the characteristic “whirlpool sign” of twisted mesenteric vessels and an abnormal orientation of the superior mesenteric vein and artery, confirming midgut volvulus on a common mesentery. Prompt surgical intervention was performed, preventing ischemic complications. These cases underscore the crucial role of ultrasound as a non-invasive, readily accessible tool for early diagnosis. Recognizing these sonographic features is essential for timely management, as delayed diagnosis can lead to bowel necrosis, resection, and increased morbidity.