Clinics in diagnostic imaging (74). Midgut malrotation with volvulus

Area of Science:

• Pediatric Surgery
• Diagnostic Imaging
• Gastrointestinal Radiology

Background:

• Midgut malrotation with volvulus is a severe congenital anomaly presenting as a surgical emergency in neonates.
• Early detection and surgical management are crucial for preventing intestinal ischemia and ensuring favorable outcomes.
• Radiological imaging is indispensable for confirming the diagnosis and guiding surgical planning.

Observation:

• A two-day-old male infant presented with acute bilious vomiting, a significant clinical sign.
• Upper gastrointestinal (GI) examination revealed findings consistent with midgut malrotation and associated volvulus.
• Surgical exploration confirmed ischemic but viable bowel, necessitating prompt intervention.

Findings:

• Radiological features indicative of midgut malrotation and volvulus were identified on upper GI imaging.
• The imaging findings correlated with the intraoperative assessment of bowel viability.
• This case highlights the diagnostic utility of upper GI examinations in neonates with suspected midgut volvulus.

Implications:

• Prompt radiological diagnosis of midgut malrotation with volvulus can significantly improve patient outcomes.
• Timely surgical intervention based on imaging findings is essential to prevent catastrophic complications.
• Understanding the radiological signs of malrotation and volvulus aids pediatric surgeons and radiologists in managing this critical condition.