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Malrotation with midgut volvulus: CT findings of bowel infarction

Jeremy Aidlen1, Sudha A Anupindi, Diego Jaramillo

  • 1Department of Surgery, University of Massachusetts Medical Center, Worchester, MA, USA.

Pediatric Radiology
|November 13, 2004
PubMed

Insights

Midgut volvulus, a complication of intestinal malrotation, is diagnosed with imaging like CT scans. Contrast-enhanced CT helps detect bowel perfusion issues, crucial for timely treatment in children.

Area of Science:

  • Pediatric Radiology
  • Abdominal Imaging
  • Surgical Pathology

Background:

  • Intestinal malrotation is a congenital anomaly where the intestines fail to rotate properly during fetal development.
  • Midgut volvulus, a surgical emergency, arises from malrotation, leading to bowel obstruction and potential ischemia.
  • Early diagnosis and intervention are critical to prevent severe morbidity and mortality in pediatric patients.

Observation:

  • Conventional contrast fluoroscopy, ultrasound (US), and computed tomography (CT) are diagnostic modalities for midgut volvulus.
  • Contrast-enhanced CT is a rapid and thorough imaging technique for acute abdominal conditions in children.
  • CT effectively identifies bowel wall perfusion abnormalities, essential for managing midgut volvulus.

Findings:

  • This case highlights additional computed tomography features indicative of bowel infarction in a pediatric patient with confirmed malrotation and midgut volvulus.
  • Contrast-enhanced CT aids in recognizing compromised bowel perfusion, a key indicator of infarction.
  • The study emphasizes the comprehensive utility of CT in evaluating complex pediatric abdominal emergencies.

Implications:

  • Recognizing subtle CT findings of bowel infarction can lead to earlier surgical intervention for midgut volvulus.
  • Improved diagnostic accuracy through advanced imaging like contrast-enhanced CT can significantly reduce complications and mortality rates.
  • This case contributes to the understanding of imaging characteristics for pediatric bowel infarction secondary to malrotation.

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