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Midgut volvulus in infants: diagnosis with US. Work in progress
J C Leonidas1, N Magid, N Soberman
1Department of Radiology, Schneider Children's Hospital, Long Island Jewish Medical Center, New Hyde Park, NY 11042.
Radiology
|May 1, 1991
Summary
Ultrasound (US) can detect signs of midgut malrotation with volvulus in infants. Specific findings like duodenal obstruction, thickened bowel loops, and fluid suggest this serious condition, prompting further diagnostic tests.
Area of Science:
- Pediatric Radiology
- Neonatal Imaging
- Gastrointestinal Imaging
Background:
- Midgut malrotation is a congenital anomaly that can lead to volvulus, a surgical emergency.
- Early detection of midgut malrotation complicated by volvulus is crucial for preventing serious complications.
Purpose of the Study:
- To identify specific ultrasound findings that suggest midgut malrotation complicated by volvulus in neonates and infants.
- To improve the diagnostic accuracy of ultrasound in detecting this potentially fatal condition.
Main Methods:
- Retrospective review of abdominal ultrasound (US) examinations in infants with suspected midgut malrotation.
- Correlation of US findings with clinical outcomes and confirmation diagnoses.
Main Results:
- A fluid-filled, distended duodenum on US is a nonspecific sign of duodenal obstruction and can indicate midgut malrotation.
- Dilated, thick-walled bowel loops predominantly to the right of the spine, along with peritoneal fluid, were observed in infants with midgut malrotation and volvulus.
- One infant with uncomplicated midgut malrotation only showed signs of duodenal obstruction.
Conclusions:
- Specific US findings, including duodenal obstruction, thickened bowel loops to the right of the spine, and peritoneal fluid, should raise suspicion for midgut malrotation complicated by volvulus.
- An upper gastrointestinal series is recommended for definitive diagnosis when these US findings are present.