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Published on: July 21, 2023
Adult midgut malrotation: multi-detector computed tomography (MDCT) findings of 14 cases
Bin Yang1, Wen-Hui Chen, Xiao-Feng Zhang
1Department of Radiology, Hangzhou First Municipal People's Hospital, Affiliated Hangzhou Hospital of Nanjing Medical University, Hangzhou, Zhejiang 310006, China. zjhzs1yb2003@sina.com
Purpose:
To describe MDCT findings in adult patients of midgut malrotation and to correlate the types of adult midgut malrotation with its complications.
Materials And Methods:
CT scans were performed on 14 adult patients with midgut malrotation. The images were reviewed retrospectively by one radiologist. Abnormal intestinal location, mesenteric vascular arrangement, extraintestinal anomalies and complications were evaluated and correlated with patterns of adult midgut malrotation.
Results:
The 14 cases of adult midgut malrotation revealed the following CT findings: intestinal malposition (n = 14), abnormally oriented mesenteric vessels (n = 8), extraintestinal anomalies (n = 14). These cases were classified into six types: complete nonrotation (n = 3), nonrotated duodenum and partially rotated colon (n = 6), isolated nonrotation of the duodenum (n = 2), partial rotation of the duodenum and colon (n = 1), partially rotated duodenum (n = 1) and isolated colonic partial rotation (n = 1). Four of these patients had accompanying complications, including volvulus (n = 2), right paraduodenal hernia (n = 1) and gastroduodenal intussusception (n = 1), respectively.
Conclusion:
Imaging features of adult midgut malrotation are characteristic. Adult midgut malrotation has various manifestations, and types of midgut malrotation may be closely related to their complications.
Insights
MDCT imaging reveals characteristic findings in adult midgut malrotation, with specific types correlating to complications like volvulus and hernias.
Area of Science:
- Gastrointestinal Radiology
- Abdominal Imaging
- Congenital Anomalies
Background:
- Midgut malrotation is a congenital anomaly typically diagnosed in infancy.
- Adult presentation is rare and often presents with vague symptoms, posing diagnostic challenges.
Purpose of the Study:
- To characterize multi-detector computed tomography (MDCT) findings in adult patients diagnosed with midgut malrotation.
- To establish correlations between the specific types of adult midgut malrotation and their associated complications.
Main Methods:
- Retrospective analysis of MDCT scans from 14 adult patients with confirmed midgut malrotation.
- Evaluation of intestinal position, mesenteric vascular arrangement, extraintestinal anomalies, and complications.
- Classification of malrotation types and correlation with clinical outcomes.
Main Results:
- All 14 patients exhibited intestinal malposition.
- Abnormally oriented mesenteric vessels were noted in 8 patients, and extraintestinal anomalies in all 14.
- Six types of malrotation were identified, with complications including volvulus, paraduodenal hernia, and gastroduodenal intussusception.
Conclusions:
- MDCT demonstrates distinct imaging features for adult midgut malrotation.
- The diverse manifestations of adult midgut malrotation are closely linked to the specific patterns and potential complications.
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