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Gastrointestinal Motility Disorders01:20

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Imaging Studies III: Gastrointestinal Motility Studies and Virtual Colonoscopy01:26

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The appendix, a small, narrow, blind tube extending from the inferior part of the cecum, is widely regarded as a vestigial organ, having lost much of its original function through evolution. Despite its diminished role, the appendix can become inflamed, a condition known as appendicitis.
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Postoperative Ileus Murine Model
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Intestinal malrotation and midgut volvulus.

Hidayatullah Hamidi1, Yalda Obaidy2, Sahar Maroof1

  • 1Radiology Department, French Medical Institute for Children (FMIC), Kabul, 1006, Afghanistan.

Radiology Case Reports
|September 6, 2016
PubMed
Summary
This summary is machine-generated.

A neonate with bilious vomiting and bloody stools was diagnosed with intestinal malrotation and midgut volvulus. Ultrasound revealed a whirlpool sign, enabling prompt surgical intervention for this congenital condition.

Keywords:
Intestinal malrotationMidgut volvulusUpper gastrointestinal obstruction

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Area of Science:

  • Pediatric Surgery
  • Diagnostic Imaging
  • Congenital Abnormalities

Background:

  • Intestinal malrotation is a congenital anomaly where bowel loops are abnormally positioned, leading to a shortened mesentery.
  • This anatomical variation predisposes infants to midgut volvulus, a surgical emergency characterized by twisting of the bowel.
  • Persistent bilious vomiting in neonates is a critical sign warranting urgent diagnostic evaluation.

Observation:

  • A four-day-old infant presented with persistent bilious vomiting, bloody stools, and abdominal distension.
  • Transabdominal ultrasound identified a right upper quadrant mass and the characteristic whirlpool sign on color Doppler.
  • Abdominal radiography yielded nonspecific findings, while upper gastrointestinal series confirmed duodenal obstruction.

Findings:

  • The sonographic whirlpool sign is a highly specific indicator of midgut volvulus.
  • Ultrasound, particularly with color Doppler, can rapidly diagnose intestinal malrotation with midgut volvulus.
  • Surgical intervention was promptly performed following diagnosis.

Implications:

  • Early diagnosis via ultrasound can prevent catastrophic complications associated with midgut volvulus.
  • The whirlpool sign on ultrasound obviates the need for further imaging in many cases, expediting surgical planning.
  • This case highlights the critical role of ultrasound in the timely management of neonatal intestinal emergencies.