Redundant duodenal loop
Bilious vomit. Exclude malrotation.
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Initial images are obliqued as the baby is being rolled into position. There is the initial impression of a malplaced DJ flexure on image 2. However, as the contrast continues and the baby is straightened, the contrast flows towards a normally sited DJ flexure. The initial turn was from a redundant duodenal loop.
This could easily be described as malrotation on the initial imaging. This is a particularly rare finding and the surgical team took the patient to theater to ensure that the features were simply of an enlarged duodenal loop as distinct from an odd malrotation.
Surgical findings confirmed normal position of the DJ flexure and cecum (a normal mestenteric root).