Fluoroscopy
What does the study confirm?
Contrast stays to the right of the spine which points to underlying malrotation of the gut. The duodenojejunal junction is not where it should be (to the left of midline at the level of L1).
Why is malrotation so important?
Malrotation means that the mesentery of the small bowel is short. Rather than running from the normal position of the DJ flexure (left of midline at L1) is starts much closer to the caecum. This predisposes the small bowel to volvulus.
In this case, volvulus is not clearly demonstrated. What other test could be employed?
The classic corkscrew isn't seen here. However, an ultrasound can be useful to identify volved loops of small bowel.
Contrast is injected into the stomach via the NG tube. It starts to pass into the proximal duodenum, but fails to progress into the distal duodenum. Towards the end of the study, despite waiting, contrast fails to pass to the left of the spine. At the end of the study, contrast can be seen to the right of spine.