Abstract
We are unaware of any other anatomical study which deals with normal variations in the relationship between the superior mesenteric artery (SMA) and the superior mesenteric vein (SMV). In our investigation in the majority of cases, the SMV lies to the right of the SMA. It has been suggested that ultrasonographic demonstration of a left sided SMV, is characteristic of midgut malrotation so a prospective study was undertaken in order to try to correlate the position of the mesenteric vessels on Ultrasound with the radiological diagnosis of midgut malrotation on upper GI series. 427 children (95% infants) who were planned for upper GI investigation, have had color Doppler U.S. of the mesenteric vessels before the barium study. In 67 cases, the mesenteric vessels were obscured by intestinal gas. Among them, there were 2 cases of malrotation. Three different positions of the mesenteric vessels were found in the 360 remaining cases. 1) A left sided SMV was found in 4% of the cases, all had midgut malrotation on X-rays and at surgery. 2) A mesenteric vein anterior to the SMA was found in 5% of the cases, 28% had midgut malrotation. 3) A normal right sided SMV was found in 91% of the cases. However 3% of these had midgut malrotation. There are anatomical variations in the position of the mesenteric vessels and a normal relationship between SMA and SMV does not ecxclude the possibility of intestinal malrotation. Nevertheless, ultrasound remains a useful noninvasive screening technique for the diagnosis of midgut malrotation.
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David M, Nichols DM, Li DK (1983) Superior mesenteric vein rotation: a CT sign of midgut malrotation. AJR 141: 707–708
Pracros JP, Basset T, Morin de Finfe CH, Louis D, Tran-Minh VA (1988) Aspects échographiques dans le volvulus du grèle sur malrotation chez le nouveauné. Pédiatrie 43: 525–529
Loyer E, Eggli KD (1989) Sonographic evaluation of superior mesenteric vascular relationship in malrotation. Pediatr Radiol 19: 173–175
Bill AH, Ravitch MM, Welch KJ, Benson CD, Aberdeen E, Randolph JG (1979) Malrotation of the intestine. Pediatr surgery, 3rd ed. Year Book Medical Publishers, Chicago London, pp 912–923
Mairlot MC, Willocx RG (1984) Les malrotations du tube digestif. Acta Gastroenterol Belg 47: 451–463
Howell CG, Vozza F, Shaw S, Robinson M, Srouy MN, Kraana I, Ziegler MM (1982) Malrotation, malnutrition, and ischemic bowel disease. J Pediatr Surg 17: 469–473
Potts SR, Thomas PS, Garstin WIH, McGoldrick J (1985) The duodenal triangle: a plain film sign of midgut malrotation and volvulus in the neonate. Clin Radiol 36: 47–49
Howard C, Filston, Kirks DR (1981) Malrotation — the ubiquitous anomaly. J Pediatr Surg 16: 614–620
Stewart DR, Colodny AL, Daggett WC (1976) Malrotation of the bowel in infants and children: a 15 year review. Surgery 79: 716–720
Zerin JM, Di Pietro MA (1991) Mesenteric vascular anatomy at CT: normal and abnormal appearances. Radiology 179: 739–742
Teele R (1991) Personal comments at IPR 91, Stockholm
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Dufour, D., Delaet, M.H., Dassonville, M. et al. Midgut malrotation, the reliability of sonographic diagnosis. Pediatr Radiol 22, 21–23 (1992). https://doi.org/10.1007/BF02011604
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DOI: https://doi.org/10.1007/BF02011604