Intestinal malrotation and midgut volvulus

Case contributed by Assoc Prof Frank Gaillard

Presentation

Bilious vomiting. Unwell.

Patient Data

Age: 13 days
Gender: Male

Abdominal x-ray demonstrates prominent gastric outline with little distal intraluminal gas.

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

Barium meal demonstrates malrotation, with the DJ flexure not visible, and certainly not located to the left of the midline. 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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