title: Color Doppler-An effective tool for diagnosing midgut volvulus with malrotation.
abstract: BACKGROUND
  Malrotation with midgut volvulus is a common surgical emergency in children. A diagnostic tool for malrotation with characteristics ideal in emergency settings such as non-invasiveness and rapidity remains a keenly debated issue among surgeons and radiologists alike.
  
  
  METHODS
  Fifty-two pediatric patients of suspected malrotation with midgut volvulus were studied between 1998 and 2016. All patients underwent plain abdominal X-ray and Color Doppler; contrast upper gastrointestinal (GI) studywas done in some patients. All cases were operated and diagnosis was confirmed. A subset of 60 pediatric patients with nonspecific GI complaints were also examined to see relative position of superior mesenteric vein (SMV)/superior mesenteric artery (SMA) in control population.
  
  
  RESULTS
  A total of 52 suspected cases of malrotation were admitted from May 1998 to November 2015, 43 had inversion of SMA/SMV and nine had SMV anterior of SMA in Color Doppler. All 43 cases of inversion of SMA/SMV were cases of malrotation after surgical confirmation; while five out of nine cases of SMV anterior to SMA had malrotation.
  
  
  CONCLUSIONS
  In appropriate clinical settings, Color Doppler documenting the reversal or aberrant SMV/SMA axis is not only predictive but also diagnostic of malrotation of gut.
authors.affiliation: Department of Pediatric Surgery, All India Institute of Medical Sciences, Phulwari Sharif, Patna, 801 507, India.
authors.forename: Bindey
authors.initials: B
authors.lastname: Kumar
authors.affiliation: Department of Pediatrics, All India Institute of Medical Sciences, Phulwari Sharif, Patna, 801 507, India. singh.manish.15@gmail.com.
authors.forename: Manish
authors.identifier: http://orcid.org/0000-0002-3282-0498
authors.initials: M
authors.lastname: Kumar
authors.affiliation: Department of Radiology, All India Institute of Medical Sciences, Phulwari Sharif, Patna, 801 507, India.
authors.forename: Prem
authors.initials: P
authors.lastname: Kumar
authors.affiliation: Department of Pediatric Surgery, All India Institute of Medical Sciences, Phulwari Sharif, Patna, 801 507, India.
authors.forename: Amit Kumar
authors.initials: AK
authors.lastname: Sinha
authors.affiliation: Department of Gastrosurgery, Indira Gandhi Institute of Medical Sciences, Sheikhpura, Patna, 800 014, India.
authors.forename: Utpal
authors.initials: U
authors.lastname: Anand
authors.affiliation: Department of Surgery, All India Institute of Medical Sciences, Phulwari Sharif, Patna, 801 507, India.
authors.forename: Anil
authors.initials: A
authors.lastname: Kumar
mesh_terms: D002675:Child, Preschool; D004065:Digestive System Abnormalities / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D006801:Humans; D007223:Infant; D045822:Intestinal Volvulus / Q000000981:diagnostic imaging* / Q000601:surgery; D008297:Male; D017538:Mesenteric Artery, Superior / Q000002:abnormalities / Q000000981:diagnostic imaging; D008642:Mesenteric Veins / Q000002:abnormalities / Q000000981:diagnostic imaging; D011237:Predictive Value of Tests; D018615:Ultrasonography, Doppler, Color
keywords: Mesenteric vessels; Ultrasonography; Upper GI series