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Untwisting the complexity of midgut malrotation and volvulus ultrasound

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Abstract

Abdominal US is emerging as an alternative to the upper gastrointestinal (GI) series as the preferred diagnostic imaging test for midgut malrotation complicated by volvulus. Unlike the upper GI series, US is free from ionizing radiation, does not require oral contrast agent, and can be performed portably and at times remotely from the interpreting radiologist, expediting diagnosis. Although some institutions do not have a standardized US protocol for midgut volvulus, many routinely use US in the setting of an infant or child with acute abdominal signs or symptoms to evaluate for common conditions such as hypertrophic pyloric stenosis, intussusception, necrotizing enterocolitis and appendicitis. Because these common conditions can overlap in age and clinical presentation with midgut volvulus, the aim of this pictorial essay is to provide instruction on the technique and diagnostic findings of midgut volvulus on US to ensure confident, accurate interpretation, and prompt treatment.

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Authors and Affiliations

  1. Singleton Department of Radiology, Texas Children’s Hospital, 6701 Fannin St., Houston, TX, 77030, USA

    HaiThuy N. Nguyen, R. Paul Guillerman & Marla B. K. Sammer

  2. Department of Radiology, Baylor College of Medicine, Houston, TX, USA

    HaiThuy N. Nguyen, R. Paul Guillerman & Marla B. K. Sammer

  3. Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON, Canada

    Oscar M. Navarro

  4. Department of Medical Imaging, University of Toronto, Toronto, ON, Canada

    Oscar M. Navarro

  5. Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA

    Cicero T. Silva

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  1. HaiThuy N. Nguyen
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  2. Oscar M. Navarro
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  3. R. Paul Guillerman
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  4. Cicero T. Silva
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  5. Marla B. K. Sammer
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Correspondence to HaiThuy N. Nguyen.

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Nguyen, H.N., Navarro, O.M., Guillerman, R.P. et al. Untwisting the complexity of midgut malrotation and volvulus ultrasound. Pediatr Radiol 51, 658–668 (2021). https://doi.org/10.1007/s00247-020-04876-x

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  • DOI: https://doi.org/10.1007/s00247-020-04876-x

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