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Intestinal malrotation and midgut volvulus

Case contributed by: Dr Frank Gaillard

Presentation:

Bilious vomiting. Unwell.

Patient Data:

Age: 13 days
Gender: Male
Race: Caucasian

Abdominal x-ray

Modality: X-ray

Abdominal xrays demonstrates prominent gastric outline with little distal intraluminal gas.

Lateral cross-table abdominal x-ray

Modality: X-ray

Lateral cross-table shoot through demonstrates no evidence of free intraabdominal gas.

Barium meal

Modality: Barium

Barium meal demonstrates malrotation, with the DJ flexure not visible, and certainly not located to the left of the mid line. Rather the small bowel passes directly inferiorly from the second part of the duodenum with are helical path. 

Case Discussion:

This child went on to have a laparotomy. Fortunately his bowel was not infarcted, and he made an uncomplicated recovery. Everyone likes a happy ending. 

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