Intestinal malrotation in children: tutorial on radiographic diagnosis in difficult cases.
Publication/Presentation Date
3-1-1996
Abstract
PURPOSE: To analyze difficult diagnostic cases of malrotation to identify features crucial to accurate diagnosis.
MATERIALS AND METHODS: The authors reviewed the radiographs and records of 81 symptomatic children who underwent surgery with a preoperative diagnosis of malrotation. Eleven had subtle rotational abnormalities (potential false-negative examinations), and 12 had false-positive upper gastrointestinal examinations.
RESULTS: Subtle signs of malrotation included unusual redundancy of the duodenum to the right of the spine and location of the duodenojejunal junction (DJJ) medial to the left pedicle. Nevertheless, two children with variations of malrotation had normal upper gastrointestinal examinations. False-positive diagnoses resulted from failure to recognize normal variants: jejunum in the right upper quadrant as the sole finding, DJJ over the left pedicle on the anteroposterior view, "duodenum inversum," and "duodenum mobile." Three children had bowel distention that displaced the DJJ.
CONCLUSION: Diagnosis of difficult cases of malrotation may depend on recognition of anatomic subtleties. False-positive diagnoses may be avoided by appreciation of normal duodenal variants.
Volume
198
Issue
3
First Page
775
Last Page
780
ISSN
0033-8419
Published In/Presented At
Long, F. R., Kramer, S. S., Markowitz, R. I., Taylor, G. E., & Liacouras, C. A. (1996). Intestinal malrotation in children: tutorial on radiographic diagnosis in difficult cases. Radiology, 198(3), 775–780. https://doi.org/10.1148/radiology.198.3.8628870
Disciplines
Medicine and Health Sciences | Pediatrics
PubMedID
8628870
Department(s)
Department of Pediatrics
Document Type
Article