Delayed presentation of malrotation and midgut volvulus: imaging findings.
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.
Green
Page
P
Department of Radiology, University of Texas Medical Branch, Galveston, TX 77555-0709, USA.
Swischuk
Leonard E
LE
Hernandez
J Alberto
JA
D003937:Diagnosis, Differential; D004380:Duodenal Obstruction / Q000000981:diagnostic imaging* / Q000209:etiology; D005759:Gastroenteritis / Q000000981:diagnostic imaging; D006801:Humans; D045822:Intestinal Volvulus / Q000150:complications / Q000000981:diagnostic imaging; D007421:Intestine, Small / Q000002:abnormalities*; D007443:Intussusception / Q000150:complications / Q000000981:diagnostic imaging; D008286:Malabsorption Syndromes / Q000000981:diagnostic imaging / Q000209:etiology; D017538:Mesenteric Artery, Superior / Q000002:abnormalities; D014057:Tomography, X-Ray Computed; D014102:Torsion Abnormality / Q000150:complications / Q000000981:diagnostic imaging*; D014463:Ultrasonography
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