Symptomatic bowel malrotation in adults is rare. We present a patient with midgut malrotation and discuss the embryology, diagnosis and the radiographic features. A 72-year-old man presented with mild abdominal pain for two weeks. Computed Tomography (CT) revealed that twisted small bowel encircles the central superior mesenteric artery (SMA) in a whirl pattern. The patient underwent surgical correction with Ladd’s procedure and a final diagnosis of midgut volvulus was made.