Midgut volvulus

Case contributed by Hani Makky Al Salam
Diagnosis almost certain

Presentation

Bilious vomiting.

Patient Data

Age: 5 days
Gender: Male
x-ray

Prominent loops of gas-filled small bowel. No gas is seen in the rectum.

Fluoroscopy

Barium meal demonstrates a cork-screw proximal jejunum, with the DJ-flexure never reaching the left side of the abdomen, or ascending to L1. Features are in keeping with intestinal malrotation, and given the history, small bowel volvulus. 

Case Discussion

Features are in keeping with intestinal malrotation, and given the history, small bowel volvulus

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