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Vascular compromise in chronic volvulus with midgut malrotation
Pediatric Radiology
|January 1, 1987
Summary
Chronic volvulus in midgut malrotation presents with unique angiographic findings of mesenteric vessel occlusion and collateral formation. Imaging like CT and sonography aids in early diagnosis of this condition.
Area of Science:
- Gastroenterology
- Radiology
- Pediatric Surgery
Background:
- Midgut malrotation is a congenital anomaly that can lead to chronic volvulus.
- Chronic volvulus of the small bowel presents diagnostic challenges due to nonspecific clinical manifestations.
Observation:
- Angiographic findings in three cases included superior mesenteric artery and vein occlusion with collateral vessel development.
- Computed tomography (CT) revealed a whirl-like pattern of small bowel loops and dilated mesenteric vessels.
- Sonography demonstrated whirling sonolucent layers, likely representing volvulated loops and collateral vessels.
Findings:
- The observed angiographic findings suggest a pathophysiology of progressive mesenteric root twisting with compensatory collateral circulation.
- CT and sonography identified characteristic imaging patterns associated with chronic small bowel volvulus in midgut malrotation.
Implications:
- CT and sonography are valuable tools for the early diagnosis of chronic volvulus in midgut malrotation.
- Understanding the pathophysiology and imaging findings can improve patient outcomes by enabling timely intervention.