300 results match your criteria Midgut Volvulus Imaging


Left sided appendicitis - a surgical dilemma: Case report.

J Pak Med Assoc 2021 May;71(5):1483-1485

Department of East Surgical Ward, Mayo Hospital, King Edward Medical University, Lahore, Pakistan.

Left-sided abdominal pain is an uncommon presentation of acute appendicitis. When a patient presents with this complaint, appendicitis can be difficult to diagnose, thus resulting in delayed definitive therapy and increased morbidity and mortality. In this report we discuss the case of a middle-aged man, who presented with left-sided abdominal pain, and was diagnosed to be suffering from acute appendicitis along with asymptomatic midgut malrotation. Read More

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Ultrasound imaging as the first line of investigation to diagnose intestinal malrotation in children: Safety and efficacy.

J Pediatr Surg 2021 Apr 20. Epub 2021 Apr 20.

Department of Paediatric Surgery, Women's and Children's Hospital, South Australia, Australia; Discipline of Paediatrics, University of Adelaide, South Australia, Australia.

Background: Upper gastrointestinal contrast study is considered the gold standard investigation to diagnose intestinal malrotation and midgut volvulus which is potentially devastating condition. Ultrasound imaging is an alternative but has been considered unreliable due to significant false negative results. At our institution we have been using ultrasound imaging as the first line investigation to diagnose malrotation since 2008 with a preliminary study of 139 patients published in 2014. Read More

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Intrauterine midgut volvulus as a rare cause of intestinal obstruction: a case report.

J Med Case Rep 2021 May 4;15(1):239. Epub 2021 May 4.

Department of Pediatric, Şanlıurfa Mehmet Akif İnan Training and Research Hospital, Şanlıurfa, Turkey.

Background: Intrauterine midgut volvulus is a very rare, life-threatening condition, and prenatal diagnosis is difficult. In this article, we present a case of midgut volvulus followed by a pre-diagnosis of antenatal jejunal atresia.

Case Presentation: A 1-day-old Turkish male baby, who was followed with a diagnosis of antenatal jejunal atresia, with a birth weight of 3600 g, delivered by cesarean section at 38 weeks of gestation from a 19-year-old mother in her fourth pregnancy, was taken to the newborn intensive care unit. Read More

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Prenatal diagnosis of intestinal nonrotation using magnetic resonance imaging: Is it possible?

Pediatr Radiol 2021 Feb 20. Epub 2021 Feb 20.

Department of Radiology and Fetal Medicine Institute, Children's National Medical Center, 111 Michigan Ave., Washington, DC, 20010, USA.

Background: Malrotation of the bowel refers to any variation in the rotation and fixation of the gastrointestinal tract during the first trimester and is most commonly detected postnatally. Nonrotation of the bowel and incomplete rotation of the bowel are subtypes of malrotation.

Objective: To determine if the nonrotation subtype of malrotation of the bowel can be detected on prenatal magnetic resonance imaging (MRI). Read More

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February 2021

Transition to ultrasound as the first-line imaging modality for midgut volvulus: keys to a successful roll-out.

Pediatr Radiol 2021 Apr 8;51(4):506-515. Epub 2021 Jan 8.

Singleton Department of Radiology, Texas Children's Hospital, 6701 Fannin St., Houston, TX, 77030, USA.

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Untwisting the complexity of midgut malrotation and volvulus ultrasound.

Pediatr Radiol 2021 Apr 4;51(4):658-668. Epub 2021 Jan 4.

Singleton Department of Radiology, Texas Children's Hospital, 6701 Fannin St., Houston, TX, 77030, USA.

Abdominal US is emerging as an alternative to the upper gastrointestinal (GI) series as the preferred diagnostic imaging test for midgut malrotation complicated by volvulus. Unlike the upper GI series, US is free from ionizing radiation, does not require oral contrast agent, and can be performed portably and at times remotely from the interpreting radiologist, expediting diagnosis. Although some institutions do not have a standardized US protocol for midgut volvulus, many routinely use US in the setting of an infant or child with acute abdominal signs or symptoms to evaluate for common conditions such as hypertrophic pyloric stenosis, intussusception, necrotizing enterocolitis and appendicitis. Read More

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ACR Appropriateness Criteria® Vomiting in Infants.

J Am Coll Radiol 2020 Nov;17(11S):S505-S515

Specialty Chair, Riley Hospital for Children Indiana University, Indianapolis, Indiana.

Vomiting in infants under the age of 3 months is one of the most common reasons for parents to seek care from their doctor or present to an emergency room. The imaging workup that ensues is dependent on several factors: age at onset, days versus weeks after birth, quality of emesis, bilious or nonbilious vomiting, and the initial findings on plain radiograph, suspected proximal versus distal bowel obstruction. The purpose of these guidelines is to inform the clinician, based on current evidence, what is the next highest yield and most appropriate imaging study to pursue a diagnosis. Read More

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November 2020

Internal herniation of small bowel through foramen of Winslow in the context of congenital midgut malrotation.

ANZ J Surg 2021 05 27;91(5):1030-1032. Epub 2020 Sep 27.

Department of General Surgery, Auckland City Hospital, Auckland, New Zealand.

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Midgut volvulus imitating acute appendicitis.

ANZ J Surg 2021 04 22;91(4):E247-E248. Epub 2020 Sep 22.

Division of Surgery, Flinders Medical Centre, Adelaide, South Australia, Australia.

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Synchronous rectal prolapse and midgut volvulus presenting as complete small bowel gangrene.

Pol Przegl Chir 2020 Jun;92(5):1-5

Department of Surgery and Transplantation, Atal Bihari Vajpayee Institute of Medical Sciences, New Delhi, India, Ram Manohar Lohia Hospital, New Delhi, India.

<b>Introduction:</b> Adult midgut malrotation is very rare. The presentation in adults is mostly subtle; the diagnosis is often made on imaging. <br><b>Case report:</b> A 32-year-old man presented with a 3-day history of an irreducible painful mass protruding per rectum, followed by abdominal pain and constipation. Read More

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Acute abdomen caused by a large solitary jejunal diverticulum that induced a midgut volvulus. Report of a case.

Int J Surg Case Rep 2020 12;74:109-112. Epub 2020 Aug 12.

Department of Surgery, MedStar Washington Hospital Center, Washington, DC, USA. Electronic address:

Background: Jejunal diverticula are a rare subtype of false diverticula found in the gastrointestinal tract. When present, they are usually multiple, in the proximal jejunum and asymptomatic. Rarely, they can cause acute complications that can develop into an acute abdomen requiring surgical intervention. Read More

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Duplication cyst with midgut volvulus in a neonate: an unusual presentation.

BMJ Case Rep 2020 Aug 26;13(8). Epub 2020 Aug 26.

Department of Paediatric Surgery, Kasturba Medical College, Manipal, India.

Incomplete intestinal fixation or malrotation of gut with midgut volvulus is one of the important causes of bilious vomiting in neonates. The incidence of malrotation of gut in population is 4% and that of duplication cyst is 1:4500. Patients with malrotation are prone to develop midgut volvulus due to their narrow mesenteric base demanding urgent surgical intervention. Read More

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Diagnostic laparoscopy to exclude malrotation following inconclusive upper gastrointestinal contrast study in infants.

Pediatr Surg Int 2020 Oct 17;36(10):1221-1225. Epub 2020 Aug 17.

Department of Paediatric Surgery and Urology, Southampton Children's Hospital, Southampton, UK.

Purpose: We report the use of diagnostic laparoscopy as an alternative to laparotomy in the investigation of infants with clinical features concerning for malrotation and inconclusive upper gastrointestinal contrast study.

Method: Case note review of all infants in whom laparoscopy was performed during 2016-2020 to investigate for possible malrotation.

Results: Eight infants were identified. Read More

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October 2020

Time-Driven Activity-Based Cost Comparison of Three Imaging Pathways for Suspected Midgut Volvulus in Children.

J Am Coll Radiol 2020 Dec 19;17(12):1563-1570. Epub 2020 Jul 19.

Department of Radiology, Texas Children's Hospital, Houston, Texas; University of Texas, School of Public Health, Houston, Texas. Electronic address:

Objective: To use time-driven activity-based costing to compare the costs of pathways for evaluating suspected pediatric midgut volvulus using either fluoroscopic upper gastrointestinal examination (UGI) or focused abdominal ultrasound (US).

Methods: Process maps were created through patient shadowing, medical record review, and frontline staff interviews. Using time-driven activity-based costing methodology, practical capacity cost rates were calculated for personnel, equipment, and facility costs. Read More

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December 2020

Misdiagnosing Midgut Volvulus in Very Preterm Infants: What is the Impact of Delay Before Surgery?

Indian J Pediatr 2021 01 15;88(1):89-90. Epub 2020 Jul 15.

Department of General Pediatric Surgery, Robert-Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.

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January 2021

Exploring the neglected segment of the intestine: the duodenum and its pathologies.

Pol J Radiol 2020 8;85:e230-e244. Epub 2020 May 8.

Department of Radiology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.

Herein we reviewed the computed tomography (CT) findings of a spectrum of pathological entities affecting the duodenum. We discuss the CT findings of some congenital, inflammatory, traumatic, and neoplastic pathologies of the duodenum along with the conventional barium studies of selected conditions. Pathologies of this C-shaped intestinal segment, derived from both foregut and midgut, are often overlooked in clinical practice and radiological literature. Read More

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Making the diagnosis of midgut volvulus: Limited abdominal ultrasound has changed our clinical practice.

J Pediatr Surg 2020 Dec 3;55(12):2614-2617. Epub 2020 May 3.

Phoenix Children's Hospital, Phoenix, AZ.

Purpose: To assess the diagnostic accuracy of limited abdominal ultrasound (US) examination for midgut volvulus (MGV) and to evaluate how clinical practice has changed in a free-standing children's hospital leading to the near obsolescence of upper GI (UGI) studies for the diagnosis of MGV.

Materials And Methods: All patients with suspected MGV who underwent abdominal US during 2016-2017 were identified using keyword search tools in the radiology information system. Retrospective, blinded image review was performed by a certificate of added qualification (CAQ), board certified pediatric radiologist. Read More

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December 2020

Prenatal diagnosis of midgut volvulus with jejunal atresia by ultrasonography.

J Obstet Gynaecol Res 2020 Jul 25;46(7):1203-1206. Epub 2020 May 25.

Department of Ultrasound, Guangdong Women and Children's Hospital, Guangzhou, China.

Prenatal midgut volvulus is difficult to diagnose, and it is particularly difficult to evaluate the degree of rotation, which may be related to prognosis. We present a rare case of prenatal midgut volvulus with a 720° rotation around the superior mesenteric artery diagnosed based on ultrasonography, and jejunal atresia was noted at the same time. This condition was supported by prenatal magnetic resonance imaging and the subsequent postnatal operation. Read More

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Choledochal cyst mimicker-When small bowel length matters.

Int J Surg Case Rep 2020 29;68:132-135. Epub 2020 Feb 29.

Department of Surgery, University of the West Indies, San Fernando General Hospital, San Fernando, Trinidad and Tobago; Westshore Medical Limited, Cocorite, Trinidad and Tobago.

Objective: Due to the risk of malignancy, the established management of choledochal cysts mandates bile duct excision and biliary reconstruction. While the reconstructive procedure of choice for most surgeons has traditionally been hepatico-jejunostomy, this may not be feasible in selected cases due to immobility or inadequacy of the jejunum. The following case will outline the management of a 32-year-old woman with short bowel syndrome, who was diagnosed with choledocholithiasis and a type 1 choledochal cyst. Read More

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February 2020

Antenatal predictors of intestinal pathologies in fetal bowel dilatation.

J Paediatr Child Health 2020 Jul 19;56(7):1097-1100. Epub 2020 Feb 19.

Ultrasound Department, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.

Aim: Fetal bowel dilatation (FBD) in the late trimester of pregnancy can be related with varies of prognosis. Our aims were to obtain antenatal factors that might have relevance for the distinct prognosis with FBD.

Methods: Seven features of 68 pregnancies presented with FBD were assessed. Read More

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Adult Presentations of Congenital Midgut Malrotation: A Systematic Review.

World J Surg 2020 06;44(6):1771-1778

Ealing Hospital, London North West University Healthcare NHS Trust, Uxbridge Road, London, UB1 3HW, UK.

Background: Adult midgut malrotation is a rare cause of an acute abdomen requiring urgent intervention. It may also present in the non-acute setting with chronic, non-specific symptoms. The objective of this study is to identify the clinical features, appropriate investigations and current surgical management associated with adult malrotation. Read More

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The role of sonography in differentiating congenital intrinsic duodenal anomalies from midgut malrotation: emphasizing the new signs of duodenal and gastric wall thickening and hyperechogenicity.

Pediatr Radiol 2020 05 23;50(5):673-683. Epub 2020 Jan 23.

Department of Medical Imaging, University of Toronto, Toronto, ON, Canada.

Background: The clinical and plain radiographic differentiation of congenital intrinsic duodenal anomalies (atresia, web, stenosis) from intestinal malrotation is not always clear. Although sonography has been documented as an important diagnostic tool in the differentiation of these two entities, its role is still not widely appreciated and it is still not universally utilized in this clinical setting.

Objective: To assess the usefulness of sonographic features of the duodenal and gastric wall in the differentiation of congenital intrinsic duodenal anomalies from midgut malrotation in a large series of neonates and to compare them with other features on abdominal radiographs, ultrasound and upper gastrointestinal series. Read More

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[Assessment of fetal superior mesenteric artery and vein by three-dimensional power Doppler sonography].

Zhejiang Da Xue Xue Bao Yi Xue Ban 2019 Jun;48(4):453-458

Department of Ultrasonography, the Third Xiangya Hospital, Central South University, Changsha 410013, China.

Objective: To analyze the application of three-dimensional power Doppler sonography (3-DPDS) in evaluation of the superior mesenteric artery (SMA) and superior mesenteric vein (SMV) in second-trimester fetus.

Methods: Three-dimensional volume probe was used to collect the 3-DPDS blood flow images in 50 normal fetuses of 22-24 weeks and 50 fetuses of 30-32 weeks, respectively. The characteristics of three-dimensional ultrasound were analyzed. Read More

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Intrauterine Intestinal Volvulus.

J Pediatr 2020 04 20;219:278-279. Epub 2019 Dec 20.

Neonatology Department, Sant Joan de Déu Hospital, Universidad de Barcelona, BCNatal, Barcelona, Spain.

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Congenital intestinal malrotation presenting in octogenarians: a report of two cases.

Ann R Coll Surg Engl 2020 Jan 20;102(1):e12-e14. Epub 2019 Dec 20.

Ealing Hospital, London North West University Healthcare NHS Trust, Southall, London, UK.

Malrotation is part of a spectrum of small and large bowel positional and fixational abnormalities caused by the failure of the fetal intestine to complete a 270-degree rotation around the superior mesenteric artery axis. Rarely, it presents in the adult as a cause of acute small bowel obstruction. Chronic symptoms of malrotation in adults are subtle, and include intermittent abdominal pain, nausea and vomiting. Read More

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January 2020

Whirlpool sign in midgut volvulus: imaging intraoperative correlation.

ANZ J Surg 2020 06 6;90(6):1197-1198. Epub 2019 Nov 6.

Department of GI Surgery, Indraprastha Apollo Hospital, New Delhi, India.

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Nutcracker syndrome complicated with intestinal malrotation.

BMJ Case Rep 2019 Oct 10;12(10). Epub 2019 Oct 10.

Pediatrics, TOYOTA Memorial Hospital, Toyota, Aichi, Japan.

Nutcracker syndrome (NCS) is a pathological condition in which the left renal vein (LRV) is compressed between the superior mesenteric artery (SMA) and aorta. NCS can predispose patients to the onset of chronic kidney disease because of persistent increase in LRV pressure. Although NCS in children is often idiopathic, it can also be caused by underlying pathologies such as retroperitoneal tumours. Read More

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October 2019

Imaging Acute Non-Traumatic Abdominal Pathologies in Pediatric Patients: A Pictorial Review.

J Radiol Case Rep 2019 Jul 31;13(7):29-43. Epub 2019 Jul 31.

Department of Radiology, American University of Beirut Medical Center, Beirut, Lebanon.

The dilemma of acute non-traumatic abdominal pathologies in the pediatric population depends on the age of the patients and symptoms. Surgical etiologies in patients younger than 2 years of age include intussusception, pyloric stenosis, malrotation and midgut volvulus. In older patients, considerations become closer to differential etiologies in adults including acute appendicitis. Read More

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The role of sonography for depiction of a whirlpool sign unrelated to midgut malrotation in neonates.

Pediatr Radiol 2020 01 10;50(1):46-56. Epub 2019 Sep 10.

Division of General and Thoracic Surgery, Hospital for Sick Children, Toronto, ON, Canada.

Background: The sonographic whirlpool sign of volvulus due to midgut malrotation is well recognized. However, variations of the whirlpool sign may be seen in other conditions, but this observation has received little attention in the literature.

Objective: This study presents a series of neonates with a variety of causes of congenital intestinal obstruction, all associated with a whirlpool sign (unrelated to midgut volvulus), which was correctly recognized preoperatively on sonography. Read More

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January 2020