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Indian J Gastroenterol. 2017 Jan;36(1):27-31. doi: 10.1007/s12664-017-0729-5. Epub 2017 Jan 26.

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

Author information

1
Department of Pediatric Surgery, All India Institute of Medical Sciences, Phulwari Sharif, Patna, 801 507, India.
2
Department of Pediatrics, All India Institute of Medical Sciences, Phulwari Sharif, Patna, 801 507, India. singh.manish.15@gmail.com.
3
Department of Radiology, All India Institute of Medical Sciences, Phulwari Sharif, Patna, 801 507, India.
4
Department of Gastrosurgery, Indira Gandhi Institute of Medical Sciences, Sheikhpura, Patna, 800 014, India.
5
Department of Surgery, All India Institute of Medical Sciences, Phulwari Sharif, Patna, 801 507, India.

Abstract

BACKGROUND:

Malrotation with midgut volvulus is a common surgical emergency in children. A diagnostic tool for malrotation with characteristics ideal in emergency settings such as non-invasiveness and rapidity remains a keenly debated issue among surgeons and radiologists alike.

METHODS:

Fifty-two pediatric patients of suspected malrotation with midgut volvulus were studied between 1998 and 2016. All patients underwent plain abdominal X-ray and Color Doppler; contrast upper gastrointestinal (GI) studywas done in some patients. All cases were operated and diagnosis was confirmed. A subset of 60 pediatric patients with nonspecific GI complaints were also examined to see relative position of superior mesenteric vein (SMV)/superior mesenteric artery (SMA) in control population.

RESULT:

A total of 52 suspected cases of malrotation were admitted from May 1998 to November 2015, 43 had inversion of SMA/SMV and nine had SMV anterior of SMA in Color Doppler. All 43 cases of inversion of SMA/SMV were cases of malrotation after surgical confirmation; while five out of nine cases of SMV anterior to SMA had malrotation.

CONCLUSION:

In appropriate clinical settings, Color Doppler documenting the reversal or aberrant SMV/SMA axis is not only predictive but also diagnostic of malrotation of gut.

KEYWORDS:

Mesenteric vessels; Ultrasonography; Upper GI series

PMID:
28124311
DOI:
10.1007/s12664-017-0729-5
[Indexed for MEDLINE]

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