Color Doppler-An effective tool for diagnosing midgut volvulus with malrotation

Area of Science:

• Pediatric Surgery
• Diagnostic Imaging
• Gastroenterology

Background:

• Intestinal malrotation with midgut volvulus is a critical pediatric surgical emergency.
• Non-invasive and rapid diagnostic tools for this condition are highly sought after.

Purpose of the Study:

• To evaluate the diagnostic utility of Color Doppler ultrasound in identifying pediatric intestinal malrotation.
• To assess the accuracy of superior mesenteric artery (SMA) and superior mesenteric vein (SMV) axis assessment via Color Doppler.

Main Methods:

• A study of 52 pediatric patients with suspected malrotation and midgut volvulus.
• Utilized plain abdominal X-ray, Color Doppler, and contrast upper GI studies.
• Surgical confirmation of diagnosis in all patients and assessment of SMA/SMV position in 60 controls.

Main Results:

• Color Doppler revealed SMA/SMV inversion in 43 of 52 suspected cases, all confirmed as malrotation.
• An aberrant SMV anterior to SMA was observed in nine cases, with five confirmed as malrotation.
• The study demonstrated a high correlation between abnormal SMA/SMV axis and confirmed malrotation.

Conclusions:

• Color Doppler ultrasound is a predictive and diagnostic tool for intestinal malrotation in pediatric patients.
• Documenting reversal or aberrant SMV/SMA axis via Color Doppler is effective in clinical settings.
• This imaging modality offers a valuable, non-invasive approach for diagnosing malrotation.