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Midgut volvulus is a condition in which the intestine has become twisted as a result of malrotation during. Malrotation of the intestine occurs when the normal embryologic sequence of bowel development and fixation is interrupted. Although midgut volvulus is a complication of malrotation of bowel and mesenteric malfixation, primary volvulus of the small bowel is a distinctly different and rare entity characterized by torsion of the entire small bowel with normal mesenteric fixation. The condition can occur at any age but is more frequent in infants and children. The malrotated bowel is prone to torsion (as demonstrated in the first image below), which can lead to midgut volvulus. The second image, from a GI series, shows a lateral view of midgut volvulus.In neonates, malrotation with midgut volvulus classically presents with bilious vomiting and, as the radiograph below demonstrates, high intestinal obstruction. While most neonates with bilious vomiting do not have midgut volvulus, this diagnosis must be excluded.