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KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Clinical Issues
Diagnostic Checklist
TERMINOLOGY
Definitions
- Malrotation: Abnormal rotation & fixation of small bowel (SB) mesentery that can lead to complications
- Bowel obstruction by Ladd (peritoneal) bands
- Midgut volvulus (MV) due to short mesenteric base prone to twisting
- MV: Abnormal twisting of SB about superior mesenteric artery (SMA) that can lead to bowel obstruction & bowel ischemia/necrosis
- Ligament of Treitz: Suspends duodenojejunal junction (DJJ), defines normal duodenal rotation
- Ladd band: Abnormal fibrous peritoneal bands that can cause duodenal obstruction
- Bilious vomiting: Green/yellow vomit typically from obstruction of duodenum distal to ampulla of Vater
- Malrotation: Abnormal rotation & fixation of small bowel (SB) mesentery that can lead to complications
IMAGING
General Features
Radiographic Findings
Fluoroscopic Findings
Ultrasonographic Findings
CT Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
- Carroll AG et al: Comparative effectiveness of imaging modalities for the diagnosis of intestinal obstruction in neonates and infants: a critically appraised topic. Acad Radiol. 23(5):559-68, 2016
- Drewett M et al: The burden of excluding malrotation in term neonates with bile stained vomiting. Pediatr Surg Int. 32(5):483-6, 2016
- Dumitriu DI et al: Ultrasound of the duodenum in children. Pediatr Radiol. 46(9):1324-31, 2016
- Horsch S et al: Volvulus in term and preterm infants - clinical presentation and outcome. Acta Paediatr. 105(6):623-7, 2016
- Shrimal PK et al: Midgut volvulus with whirlpool sign. Clin Gastroenterol Hepatol. 14(2):e13, 2016
- Abdelhafeez AH et al: The risk of volvulus in abdominal wall defects. J Pediatr Surg. 50(4):570-2, 2015
- Coe TM et al: Small bowel volvulus in the adult populace of the United States: results from a population-based study. Am J Surg. 210(2):201-210.e2, 2015
- Kargl S et al: Volvulus without malposition--a single-center experience. J Surg Res. 193(1):295-9, 2015
- Koong JK et al: Midgut volvulus: a rare cause of intestinal obstruction in adults. ANZ J Surg. ePub, 2015
- Mitsunaga T et al: Risk factors for intestinal obstruction after Ladd procedure. Pediatr Rep. 7(2):5795, 2015
- Nakagawa T et al: A case of fetal intestinal volvulus without malrotation causing severe anemia. Jpn Clin Med. 6:1-3, 2015
- Shah MR et al: Volvulus of the entire small bowel w1th normal bowel fixation simulating malrotation and midgut volvulus. Pediatr Radiol. 45(13):1953-6, 2015
- Marine MB et al: Imaging of malrotation in the neonate. Semin Ultrasound CT MR. 35(6):555-70, 2014
- Nehra D et al: Intestinal malrotation: varied clinical presentation from infancy through adulthood. Surgery. 149(3):386-93, 2011
- Taylor GA: CT appearance of the duodenum and mesenteric vessels in children with normal and abnormal bowel rotation. Pediatr Radiol. Epub ahead of print, 2011
- Lampl B et al: Malrotation and midgut volvulus: a historical review and current controversies in diagnosis and management. Pediatr Radiol. 39(4):359-66, 2009
- Yousefzadeh DK: The position of the duodenojejunal junction: the wrong horse to bet on in diagnosing or excluding malrotation. Pediatr Radiol. 39 Suppl 2:S172-7, 2009
- Patino MO et al: Utility of the sonographic whirlpool sign in diagnosing midgut volvulus in patients with atypical clinical presentations. J Ultrasound Med. 23(3):397-401, 2004
- Strouse PJ: Disorders of intestinal rotation and fixation ("malrotation"). Pediatr Radiol. 34(11):837-51, 2004
- Chao HC et al: Sonographic features related to volvulus in neonatal intestinal malrotation. J Ultrasound Med. 19(6):371-6, 2000
- Long FR et al: Radiographic patterns of intestinal malrotation in children. Radiographics. 16(3):547-56; discussion 556-60, 1996
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Clinical Issues
Diagnostic Checklist
TERMINOLOGY
Definitions
- Malrotation: Abnormal rotation & fixation of small bowel (SB) mesentery that can lead to complications
- Bowel obstruction by Ladd (peritoneal) bands
- Midgut volvulus (MV) due to short mesenteric base prone to twisting
- MV: Abnormal twisting of SB about superior mesenteric artery (SMA) that can lead to bowel obstruction & bowel ischemia/necrosis
- Ligament of Treitz: Suspends duodenojejunal junction (DJJ), defines normal duodenal rotation
- Ladd band: Abnormal fibrous peritoneal bands that can cause duodenal obstruction
- Bilious vomiting: Green/yellow vomit typically from obstruction of duodenum distal to ampulla of Vater
- Malrotation: Abnormal rotation & fixation of small bowel (SB) mesentery that can lead to complications
IMAGING
General Features
Radiographic Findings
Fluoroscopic Findings
Ultrasonographic Findings
CT Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
- Carroll AG et al: Comparative effectiveness of imaging modalities for the diagnosis of intestinal obstruction in neonates and infants: a critically appraised topic. Acad Radiol. 23(5):559-68, 2016
- Drewett M et al: The burden of excluding malrotation in term neonates with bile stained vomiting. Pediatr Surg Int. 32(5):483-6, 2016
- Dumitriu DI et al: Ultrasound of the duodenum in children. Pediatr Radiol. 46(9):1324-31, 2016
- Horsch S et al: Volvulus in term and preterm infants - clinical presentation and outcome. Acta Paediatr. 105(6):623-7, 2016
- Shrimal PK et al: Midgut volvulus with whirlpool sign. Clin Gastroenterol Hepatol. 14(2):e13, 2016
- Abdelhafeez AH et al: The risk of volvulus in abdominal wall defects. J Pediatr Surg. 50(4):570-2, 2015
- Coe TM et al: Small bowel volvulus in the adult populace of the United States: results from a population-based study. Am J Surg. 210(2):201-210.e2, 2015
- Kargl S et al: Volvulus without malposition--a single-center experience. J Surg Res. 193(1):295-9, 2015
- Koong JK et al: Midgut volvulus: a rare cause of intestinal obstruction in adults. ANZ J Surg. ePub, 2015
- Mitsunaga T et al: Risk factors for intestinal obstruction after Ladd procedure. Pediatr Rep. 7(2):5795, 2015
- Nakagawa T et al: A case of fetal intestinal volvulus without malrotation causing severe anemia. Jpn Clin Med. 6:1-3, 2015
- Shah MR et al: Volvulus of the entire small bowel w1th normal bowel fixation simulating malrotation and midgut volvulus. Pediatr Radiol. 45(13):1953-6, 2015
- Marine MB et al: Imaging of malrotation in the neonate. Semin Ultrasound CT MR. 35(6):555-70, 2014
- Nehra D et al: Intestinal malrotation: varied clinical presentation from infancy through adulthood. Surgery. 149(3):386-93, 2011
- Taylor GA: CT appearance of the duodenum and mesenteric vessels in children with normal and abnormal bowel rotation. Pediatr Radiol. Epub ahead of print, 2011
- Lampl B et al: Malrotation and midgut volvulus: a historical review and current controversies in diagnosis and management. Pediatr Radiol. 39(4):359-66, 2009
- Yousefzadeh DK: The position of the duodenojejunal junction: the wrong horse to bet on in diagnosing or excluding malrotation. Pediatr Radiol. 39 Suppl 2:S172-7, 2009
- Patino MO et al: Utility of the sonographic whirlpool sign in diagnosing midgut volvulus in patients with atypical clinical presentations. J Ultrasound Med. 23(3):397-401, 2004
- Strouse PJ: Disorders of intestinal rotation and fixation ("malrotation"). Pediatr Radiol. 34(11):837-51, 2004
- Chao HC et al: Sonographic features related to volvulus in neonatal intestinal malrotation. J Ultrasound Med. 19(6):371-6, 2000
- Long FR et al: Radiographic patterns of intestinal malrotation in children. Radiographics. 16(3):547-56; discussion 556-60, 1996
