Adnexal torsion is a gynecological emergency resulting from the partial or complete rotation of the ovary, often involving the fallopian tube, around its vascular pedicle. Prompt diagnosis is crucial to prevent ischemic injury and preserve ovarian function. Mature cystic ovarian teratomas are common benign neoplasms and represent a frequent cause of torsion due to their size, mobility and mass effect. The present case report describes the case of a 36-year-old woman (gravida 2, para 2) who presented several hours following the sudden onset of right lower abdominal pain, initially accompanied by nausea, both of which had resolved by the time of evaluation. A transvaginal ultrasonography revealed a right ovarian mass measuring 6.13x5.20 cm, containing two mature cystic teratomas. Gray-scale and color Doppler imaging clearly demonstrated the characteristic whirlpool sign, indicating torsion of the adnexal vascular pedicle. An emergency laparoscopy revealed the quadruple torsion of the adnexa (fallopian tube and ovary), and a right salpingo-oophorectomy was performed, as the patient had completed her family. The post-operative course of the patient was uneventful. A post-operative pathological examination confirmed the torsion of mature ovarian teratomas with associated hemorrhagic necrosis. On the whole, the present study demonstrates that the ultrasonographic whirlpool sign is a highly specific pre-operative marker for adnexal torsion, particularly in cases with multiple mature cystic teratomas. Early recognition facilitates prompt surgical intervention, minimizes ischemic injury, and may preserve ovarian function. Incorporating the focused assessment of the whirlpool sign into routine ultrasonography for acute pelvic pain enhances diagnostic accuracy and guides timely operative management.
Aim: To assess the efficacy of comprehensive physiotherapy in women after mastectomy. The paper attempts to answer the following research questions: 1. How does physiotherapy influence the size of oedema? 2. What is the correlation between physiotherapy outcomes and sociodemographic factors? 3. What is the correlation between physiotherapy outcomes and the following: BMI, time from procedure, time to the development of oedema after procedure, type of management after surgery. Materials and Methods: A total of 32 female patients after unilateral mastectomy performed at the Holy Cross Cancer Center in Kielce underwent treatment in this study. The mean age of study patients was 68.5 years. The duration of lymphoedema rehabilitation was 2 to 4 weeks (3.6 weeks on average). Almost three-fourths (71.9%) of the patients were treated for 4 weeks. The physiotherapy included respiratory exercises, kinesiotherapy, lymphatic massage, pneumatic massage, and whirlpool baths. Results: Significantly lower arm circumference values were achieved in the affected limb after physiotherapy as compared to the pre-treatment values. Conclusions: 1. Breast cancer is a difficult clinical and social problem in Poland and globally.2. Implementation of an appropriate physical therapy program both before and after surgery determines the reduction of lymphedema in women undergoing surgery.
Ovarian torsion in children is most commonly associated with benign cystic lesions. The surgical objective is to achieve early detorsion while maximizing ovarian function preservation. We report a case of an 11-year-and-8-month-old obese girl who had not yet reached menarche. She presented with persistent right lower abdominal pain lasting 40 h. Ultrasound revealed a large right-sided cystic mass with a "whirlpool sign" and an O-RADS 2 classification. CT imaging demonstrated a sizable pelvic cystic lesion with minimal fluid accumulation. Upon admission, ALT and AST levels were 278 and 122 U/L, respectively. Following a multidisciplinary evaluation, a perioperative management plan was devised, focusing on minimizing hepatic metabolic burden. Single-port laparoscopic surgery via the umbilicus confirmed 540° torsion of the right adnexal pedicle. After detorsion, an external ovarian cystectomy and ovarian reconstruction were performed outside the protective sleeve, involving controlled decompression, complete cyst wall excision, meticulous hemostasis, and tissue reconstruction. Intraoperative blood loss was approximately 20 ml. Postoperatively, transaminase levels gradually normalized, and the patient was discharged on postoperative Day 4. Histopathology revealed an ovarian follicular cyst with mild granulosa cell hyperplasia. Combining single-port laparoscopy with extracorporeal cystectomy provides a safe, minimally invasive solution for pediatric ovarian torsion. This approach reduces operative time, minimizes CO2 exposure, and preserves both ovarian function and appearance, making it a reproducible option for pediatric cases.
Adult intestinal malrotation is a rare condition and may remain undiagnosed until the occurrence of acute complications. We report the case of a 33-year-old woman presenting with acute abdominal pain. Contrast-enhanced computed tomography (CT) demonstrated an abnormal relationship between the superior mesenteric artery and vein, right-sided small bowel loops, left-sided colonic segments and a mesenteric whirlpool sign, consistent with midgut volvulus associated with intestinal malrotation. Although CT allows reliable identification of intestinal malrotation and midgut volvulus, the precise obstructive mechanism may remain undetermined preoperatively. Surgical exploration revealed a congenital Ladd's band crossing the duodenum and causing extrinsic duodenal obstruction. In addition, an associated midgut volvulus related to intestinal malrotation was confirmed intraoperatively. This case highlights the diagnostic value and limitations of CT in adult malrotation and emphasizes the importance of surgical exploration to identify the true obstructive mechanism.
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Ovarian torsion is a surgical emergency in which twisting of the ovarian vascular pedicle leads to ischaemia. Although an uncommon diagnosis in prepubescent girls, prompt recognition of this condition is essential in order to prevent ovarian necrosis, which can have long-term consequences in terms of fertility. Transabdominal ultrasound is the recommended imaging modality for diagnosing ovarian torsion; however, given the limited availability of paediatric-trained sonographers, patients may not obtain the necessary imaging in a timely manner. Point-of-care ultrasound performed by emergency department personnel has emerged as a useful adjunct to clinical examination and one that can help expedite specialist involvement. We describe two cases of prepubescent ovarian torsion presenting to our Paediatric Emergency Department, where point-of-care ultrasound played a key role in diagnosis and expediting definitive surgical management.
An 87-year-old woman with no prior history of laparotomy visited her local doctor complaining of anorexia. She was diagnosed with intestinal obstruction and initially managed conservatively with fasting; however, her condition did not improve, and she was referred to our hospital on the seventh day after symptom onset. Abdominal CT revealed a 2-cm cystic lesion on the anterior surface of the sacral pelvic cavity and a whirlpool sign near the end of the ileum. Based on these findings, a diagnosis of small intestinal volvulus and an ovarian cyst-previously noted-was made, and emergency surgery was performed on the same day. Intraoperative findings showed no ovarian abnormalities; instead, a lobulated tumor with an extramural cystic growth was identified in the ileum, 210 cm proximal to the anal verge from the ligament of Treitz and 120 cm distal to the ileocecal valve. The small intestine was twisted 360 degrees in a counterclockwise direction around the tumor. There was no evidence of ischemia in the small intestine, and a partial ileal resection including the tumor was performed. Histopathological examination confirmed a diagnosis of gastrointestinal stromal tumor (GIST) of the small intestine. Small intestinal GISTs with cystic features are relatively rare, and there have been scattered reports highlighting the difficulty in differentiating them from ovarian tumors on imaging. Additionally, secondary small bowel volvulus caused by small intestinal GISTs is also uncommon. We report these 2 characteristics of small intestinal GISTs with a review of the relevant literature.
The impact of food wastes (FW) on suspended growth systems like the activated sludge process and in large plants with anerobic digestion has been widely studied. However, information on impact on hybrid systems and biofilm processes used for intensification, as well as with aerobic biosolids digestion, is scant. This modeling study investigated the performance, operational costs, and greenhouse gas (GHG) emissions of multiple wastewater treatment technologies-membrane bioreactor (MBR), moving bed biofilm reactor (MBBR), integrated fixed film activated sludge (IFAS), membrane aerated biofilm reactor (MABR), and oxidation ditch at the 1 and 10 MGD scales. FW addition achieved effluent total nitrogen reductions of 30%-35% for the MBR, MBBR, and IFAS, up to 85% for the MABR, and up to 70% for the oxidation ditch systems. Aeration demand increased by up to 16%-34% while biosolids production and methane production rose by <13%, and 29%-38%, respectively. Food COD conversion efficiency to methane was 35%-48%. At 100% FW addition, despite a 30% increase in organic loading, the GHG emissions increased by 3.7%-11.2% for the MBR, MBBR, and IFAS, and decreased by 5.2%-11.2% for the MABR. Anaerobic digestion mitigated GHG emissions from food wastes compared to aerobic digestion, with COD-based carbon footprints 50%-90% lower than wastewater.
This article describes the isolation of Vreelandella titanicae Zn11_249 from the Salar de Uyuni (Bolivia). The genome of the bacterium is described and new information about the species Vreelandella titanicae is added to the database. However, the aim is not only to present this information, but also to provide the ecological approach of the isolate to the extreme ecosystem in which it develops and genes sequences that could improve the biotechnological capacities around this strain. Vreelandella titanicae Zn11_249 was isolated from samples of a whirlpool from the Salar de Uyuni. The nucleotide sequence of the genome has been determined and analysed. The genome contains 5,575,580 bp and has a G + C content of 54.61%. This analysis identified 4,995 coding sequences, 62 tRNA genes, 1 tmRNA gene, 12 rRNA, 1 CRSPR region and 1 repeat region. Annotation of the Vreelandella titanicae Zn11_249 genome found the metabolic genes necessary for the correct functioning of the bacterium in the niche it inhabits. On the one hand, the metabolic pathways found are related to the assimilation of carbon, nitrogen, phosphorus and sulphur. The assimilation of these compounds for an adequate development of the bacteria was related to the ecological role of Vreelandella titanicae Zn11_249 to understand its possible function and importance in the Salar de Uyuni. On the other hand, sequences encoding resistance genes were identified, possibly due to the stresses the bacteria are subjected to in this ecosystem. The sequences found included heavy metal resistance genes, genes related to oxidative stress response or to osmotic stress among others. The genes involved in the metabolism of Vreelandella titanicae Zn11_249 enable it to live on in the extreme conditions of Salar de Uyuni. This bacterium plays a crucial role in the biogeochemical cycles of carbon, nitrogen, and sulphur. Its metabolic adaptability allows them to thrive under high salinity and harsh conditions, making it a key player in the transformation and mobility of essential elements. Although based on a single genome, this primally study provides a solid foundational framework for future transcriptomic, proteomic, and experimental investigations into the ecological role and biotechnological potential of Vreelandella titanicae Zn11_249. The authors confirm all supporting data, code, and protocols have been provided within the article or through Supporting Information data files.
Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract, with 25-30% arising from the small intestine. While GISTs commonly present with abdominal pain or gastrointestinal bleeding, they may rarely manifest as acute surgical emergencies such as small bowel volvulus (SBV). Presentation with diffuse metastatic disease, including umbilical involvement (Sister Mary Joseph's nodule), at initial diagnosis is exceptionally uncommon. A 60-year-old woman presented with acute abdominal pain, vomiting, and obstipation for 2 days. Clinical examination revealed a soft, non-tender, distended abdomen with preserved bowel sounds. Imaging revealed small bowel obstruction with the characteristic whirlpool sign, a pelvic mass, diffuse peritoneal deposits, a Sister Mary Joseph's nodule, and a hepatic lesion. Emergency laparotomy revealed a 13.0 × 7.5 × 6.5 cm jejunal mesenteric mass causing a 180° anticlockwise volvulus with widespread peritoneal, omental, and umbilical nodules. Segmental jejunal resection with jejunojejunal anastomosis was performed for symptom palliation. Histopathology confirmed spindle-cell GIST, positive for CD117 and DOG1, with a mitotic count of 1/5 mm2 and a Ki-67 index of 3%. The tumor was staged as pT4 Nx M1 and categorized as high-risk. The patient recovered uneventfully and was started on treatment with imatinib mesylate. SBV secondary to GIST is rare and typically occurs in the presence of large extramural tumors that act as a lead point for mesenteric rotation. This case highlights the insidious biological behavior of GISTs, wherein prolonged asymptomatic growth may culminate in advanced metastatic disease at presentation, despite low proliferative indices. The presence of Sister Mary Joseph's nodule further signifies advanced intra-abdominal dissemination and poor prognostic implications. GISTs should be considered in cases of unexplained SBV. This case emphasizes the diagnostic challenges, the need for prompt surgical palliation, and the role of systemic tyrosine kinase inhibitors in advanced presentation of GIST.
Delayed diagnosis of pediatric ovarian torsion, a challenging emergency, can lead to ovarian loss and compromised fertility. This study aimed to develop and validate a predictive nomogram by integrating clinical, laboratory and sonographic features to facilitate the early and accurate identification of ovarian torsion. We conducted a retrospective analyses of data from 201 pediatric patients who underwent emergency surgery for suspected ovarian torsion between October 2017 and October 2025. The cohort was randomly divided into a training set (n=140) and a validation set (n=61). Using univariate and multivariate logistic regression analysis, independent predictors of ovarian torsion were identified to construct a predictive nomogram. Its performance was rigorously evaluated in three domains: (I) discrimination, assessed by the area under the receiver operating characteristic curve (AUC); (II) calibration, assessed using calibration plots, the Brier score, and the Spiegelhalter test; and (III) clinical utility, measured through decision curve analysis (DCA). The final multivariate model identified four independent predictors: age [odds ratio (OR) =0.67], neutrophil-to-lymphocyte ratio (NLR) (OR =1.23), the whirlpool sign (OR =7.09), and maximum ovarian diameter (OR =1.75). The nomogram demonstrated excellent discrimination, with an AUC of 0.915 [95% confidence interval (CI): 0.865-0.964] in the training set and 0.853 (95% CI: 0.711-0.994) in the validation set. Calibration analysis showed a strong correlation between predicted and actual probabilities. DCA verified that the nomogram offered a higher net benefit across a broad spectrum of threshold probabilities. A novel nomogram has been developed incorporating age, NLR, the whirlpool sign, and ovarian diameter to predict pediatric ovarian torsion. This tool can serve as an intuitive bedside instrument to aid clinicians in rapid risk stratification, thereby improving diagnostic decision-making and potentially increasing rates of ovarian salvage.
AIMS AND OBJECTIVES: This study aims to explore the experiences of perinatal vulnerability between expectant mothers and partners, investigating how their vulnerabilities interact, accumulate, or resolve, and identifying coping strategies that strengthen resilience and mutual support. BACKGROUND: The perinatal period presents significant physical, emotional, and psychological challenges that increase vulnerability for both mothers and partners. While most research focuses primarily on maternal vulnerability, less attention is given to partners and the couple’s dynamic. A deeper understanding of these interrelated vulnerabilities is essential for improving perinatal care. DESIGN: A phenomenological qualitative study was conducted through in-depth interviews with 40 participants (22 mothers and 18 partners) at a tertiary hospital in Wuhan, China. Data were analyzed using a thematic analysis approach. The study was designed and reported according to the Consolidated Criteria for Reporting Qualitative Research checklist. RESULTS: Three main themes emerged: (1) “Not Just Her Pain”: Joint Immersion in the Whirlpool of Vulnerability; (2) “We Touch Each Other’s Vulnerability”: The Complex Interweaving of Dual Vulnerability; and (3) “This Is a New Beginning”: Transformation and Growth Through Vulnerability. CONCLUSIONS: This study highlights the need to recognize the interrelated vulnerabilities of both expectant mothers and partners. Positive communication, mutual support, and interrelated decision-making are essential in reducing stress and fostering resilience. The study also enhances healthcare professionals’ ability to identify vulnerable populations not solely based on external factors, enabling more tailored and effective care. RELEVANCE TO CLINICAL PRACTICE: Healthcare providers should adopt a couple-centered approach in perinatal care, emphasizing joint decision-making and emotional support. This approach can improve perinatal outcomes and strengthen the emotional bonds within families.
We present a novel particle flow map framework for the high-fidelity simulation of complex two-phase flows. Our method is built upon a unified Lagrangian formulation in which a shared flow map jointly governs the phase interface evolution and the underlying fluid dynamics. For interface tracking, our particles drive a particle-flow-map-based level set equipped with a hybrid reinitialization strategy, effectively preserving sub-grid geometric features while ensuring robust topological stability. For two-phase dynamics, we introduce an impulse-based solver that reformulates the impulse path integration to depend solely on the continuous velocity field, enabling efficient and accurate handling of interfacial discontinuities without artificial smoothing. By leveraging the particle flow map's inherently low-dissipation tracking of both geometry and dynamics, our framework achieves enhanced geometric accuracy and physical fidelity relative to existing two-phase solvers. Our framework faithfully captures the intricate interplay between intense vortical motion and complex interface geometry, as evidenced by the reproduction of a broad range of challenging phenomena, including interacting bubble rings, breaking waves, and whirlpool drainage.
An acute scrotum is an urological emergency. One of its most important causes is testicular torsion, which can result in testicular necrosis unless quickly diagnosed and treated. Along with point-of-care ultrasound (POCUS), the Testicular Workup for Ischemia and Suspected Torsion (TWIST) score can be used to differentiate between testicular torsion and other causes of an acute scrotum. However, their diagnostic performance when undertaken by emergency physicians (EPs) and paediatricians in the emergency department (ED), as opposed to urologists/radiologists, is uncertain. This retrospective observational study investigated patients aged ≤15 years with an acute scrotum who visited a paediatric tertiary care hospital's ED between March 2018 and August 2022. The diagnostic accuracy of the TWIST score and POCUS when performed by EPs and paediatricians to diagnose testicular torsion was calculated. Each TWIST score served as a cut-off. For practical purposes, a cutoff ≥3 points was used for sensitivity and the negative predictive value (NPV), and a cutoff ≥5 points was used for specificity and the positive predictive value (PPV). The final diagnosis served as the reference standard. Of 512 patients, 55 (11%) had testicular torsion. The TWIST score had 91% sensitivity (95% CI 80%-97%), 95% specificity (95% CI 93% to 97%), 63% PPV (95% CI 50% to 75%) and 99% NPV (95% CI 97% to 100%). When positivity was defined as either impaired testicular blood flow or the whirlpool sign, the sensitivity, specificity, PPV and NPV were 96% (95% CI 87% to 100%), 95% (95% CI 93% to 97%), 70% (95% CI 58% to 80%) and 100% (95% CI 98% to 100%) respectively. Although the TWIST score and POCUS had high diagnostic accuracy for paediatric testicular torsion when performed by EPs or paediatricians in the ED, the non-negligible, false-negative rate indicated that the TWIST score should be used for risk stratification rather than as an exclusionary method.
Omental torsion is a rare cause of acute abdomen, with approximately 400 cases reported in the literature, only a few of which were diagnosed preoperatively. The number of reported cases in pediatric patients is relatively limited. Diagnosis is challenging because the nonspecific clinical presentation often mimics other acute abdominal conditions, particularly appendicitis. We report the case of a 15-year-old male who was presented to the emergency department with a 5-day history of abdominal pain. Clinical and laboratory findings suggested an inflammatory process; however, imaging studies demonstrated a normal appendix. Computed tomography revealed the vascular pedicle sign and the whirlpool sign, leading to a preliminary diagnosis of omental torsion. The patient underwent successful laparotomic omentectomy due to persistent severe pain and suspected recurrence despite conservative management. They were discharged on postoperative day 3. Omental torsion should be included in the differential diagnosis of patients presenting with acute abdominal pain. This case highlights the importance of radiological evaluation in pediatric patients, as accurate imaging can inform appropriate clinical management and help avoid unnecessary surgery. Nevertheless, laparoscopic surgery remains a valuable option when conservative management proves ineffective.
This study aimed to investigate the temporal evolution of ultrasound signs in patients with testicular torsion (TT) and correlate these delays with testicular salvageability and long-term reproductive outcomes. This retrospective study included 89 patients with TT treated from 2020 to 2025. Based on time from symptom onset to treatment, patients were divided into three groups: hyperacute (<6 hours), subacute (6-12 hours) and delayed (>12 hours). We collected baseline data, ultrasound findings, testicular salvage rates, reproductive hormones levels and semen analysis. We used Spearman correlation and binary logistic regression to analyse the association of ultrasound features, and time windows, with the salvage rate. The testicular salvage rates of the three groups were 96.8%, 62.1%, and 41.4%, respectively (p < 0.05). Ultrasonographic features evolved with time: the prevalence of heterogeneous parenchymal echo increased while the whirlpool sign decreased (all p < 0.05). The delayed group showed higher follicle stimulating hormone (FSH)/luteinizing hormone (LH) levels and poorer semen quality (p < 0.05). Logistic regression identified a time window <6 hours as an independent protective factor (odds ratio (OR) = 0.036, 95% confidence interval (CI): 0.003-0.473, p = 0.011), whereas uneven testicular echogenicity (OR = 4.451, 95% CI: 1.257-15.763, p = 0.021), a positive whirlpool sign (OR = 4.445, 95% CI: 1.124-17.588, p = 0.033), and absent blood flow (OR = 4.446, 95% CI: 1.091-18.123, p = 0.037) were independent risk factors for salvage failure. The dynamic evolution of ultrasound findings provides an objective risk assessment basis for time sensitive stratified management of acute scrotum, supporting clinical grading and expedited intervention decisions. The 6-hour threshold may be a critical cutoff for both testicular survival and fertility preservation. For suspected torsion, surgical exploration should be prepared alongside ultrasound to minimize the time to treatment.
To develop and validate preoperative nomograms for predicting pediatric adnexal torsion (AT) and post-torsion adnexal necrosis using clinical, laboratory, and ultrasonographic parameters. Retrospective cohort study. Single-center medical institution (Tianjin Children's Hospital). A total of 186 girls (≤18 years) with suspected AT who underwent surgical exploration between March 2019 and January 2025. Patients were randomly divided into training (n = 130) and test (n = 56) cohorts. Candidate variables including demographic characteristics, symptoms, laboratory indices, and ultrasound findings were screened using least absolute shrinkage and selection operator (LASSO) regression. Multivariable logistic regression models were constructed to predict AT and, among confirmed AT cases, adnexal necrosis. Model performance was evaluated by area under the receiver operating characteristic curve (AUC), calibration curves, and decision curve analysis. Adnexal torsion was confirmed in 67 patients (36.0%), of whom 21 (31.3%) had pathological adnexal necrosis. For AT prediction, age, abdominal tenderness, systemic immune-inflammation index (SII), and the ultrasonographic whirlpool sign were identified as independent predictors and incorporated into a nomogram. This model demonstrated good discrimination (AUC 0.933 in the training cohort and 0.891 in the test cohort) with satisfactory calibration. Among patients with confirmed AT, pan-immune-inflammation value (PIV) and thrombin time (TT) independently predicted adnexal necrosis and were used to construct a separate necrosis nomogram, achieving an AUC of 0.811. Both models provided favorable net clinical benefit across clinically relevant threshold probabilities. These nomograms provide a clinically accessible framework for preoperative risk stratification of pediatric AT and adnexal necrosis, leveraging routine clinical, laboratory, ultrasonographic, and emerging inflammatory indices.
To develop a deep learning model for differential diagnosis of acute scrotum using single ultrasound (US) images. We analysed 1172 patients with acute scrotal pain evaluated by Doppler US at four hospitals. From each case, we selected a representative axial colour Doppler US image. We trained a binary classification model to distinguish torsion from non-torsion using an EfficientNet architecture. The dataset was split 70% for training and 30% for validation. We addressed class imbalance with data augmentation and class weighting. Class Activation Mapping was used to interpret model decisions. The model achieved robust performance: accuracy 97%, precision 98%, sensitivity 97%, and F1 score 97%. Class activation mapping heatmaps localised decision-making to pathologically critical regions, including absent testicular blood flow and whirlpool signs. In a 20-patient prospective pilot study, the system correctly identified both surgically confirmed torsion cases, with one non-torsion case misclassified as torsion. A deep learning model demonstrated promising diagnostic performance in differentiating acute scrotal emergencies using single US images. Its feasibility was preliminarily assessed in a small pilot study. These findings support further investigation, with larger and more balanced multicentre studies required to establish clinical utility and effective workflow integration.
Adnexal torsion is a rare condition, but it should be considered in any pregnant patient with acute-onset abdominal pain. In this case report, a pregnant woman at 35 weeks of gestation presented with one week of alternating abdominal pain. Sonography showed an enlarged ovary with normal Doppler flow, but a typical whirlpool sign suggestive of ovarian torsion. A minilaparotomy was performed, which confirmed left-sided adnexal torsion. The ovary was detorsed, resulting in partial restoration of the ovary's colour. A cystectomy was performed, and the patient was discharged the following day.
A volvulus in cases of non-rotation in newborns is a neonatal surgical emergency that is associated with high mortality if there is a delay in diagnosis and therapy. In addition to clinical signs such as bilious vomiting, bloody stools, a tender abdomen, and a lethargic patient, the diagnosis can be quickly made by sonographic evidence showing the "whirlpool sign," allowing for the initiation of surgical therapy. We report on a full-term male newborn who was unremarkable at the routine U2 examination except for a weight loss of just under 10%. On the third day of life, the newborn began bilious vomiting and passed bloody stools. A suspected diagnosis of volvulus was made via sonography and was treated with immediate, intestine-preserving surgery. Ein Volulus bei Non-Rotation ist Neugeborenen ein neonatologisch-kinderchirurgischer Notfall, der bei Diagnose- und Therapieverzögerung mit einer hohen Letalität vergesellschaftet ist. Neben klinischen Hinweisen wie galligen Erbrechen, blutigem Stuhl, druckdolenten Abdomen und lethargischen Patienten, kann die Diagnose durch den sonographischen Nachweis mit Darstellung des „Whirpool-Zeichens“ rasch gestellt und die operative Therapie eingeleitet werden. Wir berichten über ein reifes männliches Neugeborenes, was bei der Routineuntersuchung U2 bis auf eine Gewichtsabnahme von knapp 10% unauffällig war. Am dritten Lebenstag erbrach das Neugeborene gallig und setzte blutigen Stuhl ab. Sonographisch konnte die Verdachtsdiagnose Volvulus gestellt werden und mittels sofortiger Operation darmerhaltende versorgt werden.