Intestinal malrotation

Case contributed by Julius Rozmiarek
Diagnosis certain

Presentation

Billious vomiting and abdominal distension

Patient Data

Age: 22 days
Gender: Female
x-ray

Abdominal x-ray demonstrates a prominent gastric outline with little distal intraluminal gas, and no air in the rectum. Lateral shoot through demonstrates no evidence of free intraabdominal gas.

Fluoroscopy

Barium administered via naso-gastric tube, demonstrates malrotation with the DJ flexure not on the left side of the abdomen. The small bowel passes inferiorly from the second part of the duodenum.

Case Discussion

The patient had a laparotomy, where malrotation was confirmed. No bowel infarction observed. A week after the procedure the child developed ileus, but was treated conservatively and made an uncomplicated further recovery.

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