Imaging of Clinically Suspected Malrotation in Children


Key Points

■ Malrotation of the bowel is associated with risk of intestinal volvulus and can be fatal (strong evidence). Volvulus is a surgical emergency that is treated with the Ladd procedure (strong evidence).

■ Infants and children diagnosed with symptomatic malrotation (without volvulus) should undergo Ladd procedure to fix the bowel and prevent future volvulus and intestinal obstruction from Ladd’s bands (moderate evidence).

■ Although consensus is lacking, asymptomatic children beyond infancy should undergo prophylactic Ladd procedure to avoid catastrophic midgut volvulus (limited evidence).

■ The imaging test of choice is the upper gastrointestinal (UGI) series to diagnose or exclude malrotation (moderate evidence).

■ 15–30% of UGI studies in children are indeterminate for malrotation versus normal variation due to the overlap of normal findings with malrotation, the lack of consensus on UGI positive findings and technique, and the lack of consensus for when surgeons should perform prophylactic Ladd procedure (insufficient evidence).


Moderate Evidence Chylous Ascites Duodenal Obstruction Bilious Emesis Heterotaxy Syndrome 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.Department of Radiology, Emory University School of MedicineAtlantaUSA

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