Version May 2024
| Imaging modality | Findings suggestive of intestinal malrotation |
| Plain radiograph | Nasogastric or orogastric tube that extends into an abnormally positioned duodenum |
| The "double-bubble" sign of duodenal obstruction | |
| Ultrasonography* | Abnormal position of the superior mesenteric vein (anterior or to the left of the SMA) |
| Third part of the duodenum does not pass between the SMA and the aorta | |
| Dilated duodenum (indicating duodenal obstruction) | |
| The "whirlpool" sign of volvulus (twisting of vessels around the base of the mesenteric pedicle) | |
| Upper GI contrast study¶ | A clearly misplaced duodenum (ie, ligament of Treitz on the right side of the abdomen) that has a "corkscrew" appearance |
| Duodenal obstruction, which may appear similar to that seen with duodenal atresia or may have more of a "beak" appearance if a volvulus is present | |
| Entire small bowel located in the right abdomen | |
| Barium enema | Complete obstruction of the transverse colon, particularly if the head of the barium column has a beaked appearance |
| Entire colon located in the left abdomen | |
| Computed tomography with intravenous contrastΔ | Third part of duodenum does not pass between the SMA and aorta |
| Proximal bowel is mostly to the right of midline | |
| The "whirlpool" sign of volvulus (twisting of vessels around the base of the mesenteric pedicle) | |
| Abnormal position of the superior mesenteric vein (anterior or to the left of the SMA) |
GI: gastrointestinal; SMA: superior mesenteric artery.
* In many institutions with experienced pediatric radiologists, ultrasonography is performed as the initial screening examination for malrotation. If the examination is negative or indeterminate in patients with acute signs of obstruction (eg, bilious vomiting and/or abdominal distension) or in a neonate with bilious vomiting, then an upper GI contrast study should still be performed.
¶ An upper GI contrast study is the gold standard diagnostic study in infants and children with suspected intestinal malrotation. If ultrasonography is negative or equivocal, patients with suspected malrotation should undergo a limited upper GI series.
Δ Although not the best test for confirming intestinal malrotation, computed tomography of the abdomen may provide the diagnosis of malrotation when it is performed for other reasons.آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟
