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Delayed presentation of malrotation and midgut volvulus: imaging findings

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Abstract

Midgut volvulus presenting outside the neonatal period often manifests with less than classic findings. One must be ever vigilant for any deviation from normal when imaging the gastrointestinal tract in these patients. Plain films often are noncontributory, and gastrointestinal imaging findings frequently are subtle and not exactly the same as those seen in classic cases in the neonatal period. Cases are presented illustrating the following: abnormal but less than classic small bowel location and configuration, malabsorption and fortuitous spiraling of a nasogastric tube, viral gastroenteritis and pseudo intussusception, intractable vomiting and dehydration with abnormal cecal position, and duodenal obstruction: pseudo SMA syndrome. Fortunately, one now can confirm one’s suspicions with computed tomography and ultrasound in terms of determining whether the superior mesenteric artery and superior mesenteric vein positions are normal or reversed.

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References

  1. Brandt ML, Pokorny WJ, McGill CW, Harberg FJ (1985) Late presentation of midgut malrotation in children. Am J Surg 150:767–771

    Article  PubMed  CAS  Google Scholar 

  2. Pelucio M, Haywood Y (1994) Midgut volvulus: an unusual case of adolescent pain. Am J Emerg Med 12:167–171

    Article  PubMed  CAS  Google Scholar 

  3. Yanez R, Spitz L (1986) Intestinal malrotation presenting outside the neonatal period. Arch Dis Child 61:682–685

    Article  PubMed  CAS  Google Scholar 

  4. Kealey WDC, McCallion WA, Brown S, Potts SR, Boston VE (1996) Short note: midgut volvulus in children. Brit Jour Surg 83:105–106

    Article  CAS  Google Scholar 

  5. Powell DM, Othersen HB, Smith CD (1989) Malrotation of the intestines in children: the effect of age on presentation and therapy. J Pediatric Surg 24:777–780

    Article  CAS  Google Scholar 

  6. Sprigland N, Brandt ML, Yazbeck S (1990) Malrotation presenting beyond the neonatal period. J Pediatr Surg 25:1139–1142

    Article  Google Scholar 

  7. Kamal IM (2000) Diffusing the intra-abdominal ticking bomb: intestinal malrotation in children. CMAJ 162:1315–1317

    PubMed  CAS  Google Scholar 

  8. Millar AJW, Rode H, Brown RA, Cywes S (1987) The deadly vomit: malrotation and midgut volvulus. Pediatr Surg Int 2:172–176

    Article  Google Scholar 

  9. Bonadio WA, Clarkson T, Naus J (1991) The clinical features of children with malrotation of the intestine. Pediatr Emerg Care 7:348–349

    Article  PubMed  CAS  Google Scholar 

  10. Mori H, Hayashi K, Futagawa S, Uetani M, Yanagi T, Kurosaki N (1987) Vascular compromise in chronic volvulus with midgut malrotation. Pediatr Radiol 17:277–281

    Article  PubMed  CAS  Google Scholar 

  11. Zerin JM, Dipietro M (1992) Superior mesenteric vascular anatomy at US in patients with surgically proved malrotation of the midgut. Radiology 183:693–694

    PubMed  CAS  Google Scholar 

  12. Pracos JP, Sann L, Genin G et al (1992) Ultrasound diagnosis of midgut volvulus: the “whirlpool” sign. Pediatr Radiol 22:18–20

    Article  Google Scholar 

  13. Shimanuki Y, Aiharat T, Takano H et al (1996) Clockwise whirlpool sign at color Doppler US: an objective and definite sign of midgut volvulus. Radiology 199:261–264

    PubMed  CAS  Google Scholar 

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Correspondence to Leonard E. Swischuk.

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From the University of Texas Medical Branch, Radiology Department, Galveston, TX, 77555-0379.

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Green, P., Swischuk, L.E. & Hernandez, J.A. Delayed presentation of malrotation and midgut volvulus: imaging findings. Emerg Radiol 14, 379–382 (2007). https://doi.org/10.1007/s10140-007-0662-5

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  • DOI: https://doi.org/10.1007/s10140-007-0662-5

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