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Adult midgut malrotation: multi-detector computed tomography (MDCT) findings of 14 cases

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Abstract

Purpose

To describe MDCT findings in adult patients of midgut malrotation and to correlate the types of adult midgut malrotation with its complications.

Materials and methods

CT scans were performed on 14 adult patients with midgut malrotation. The images were reviewed retrospectively by one radiologist. Abnormal intestinal location, mesenteric vascular arrangement, extraintestinal anomalies and complications were evaluated and correlated with patterns of adult midgut malrotation.

Results

The 14 cases of adult midgut malrotation revealed the following CT findings: intestinal malposition (n = 14), abnormally oriented mesenteric vessels (n = 8), extraintestinal anomalies (n = 14). These cases were classified into six types: complete nonrotation (n = 3), nonrotated duodenum and partially rotated colon (n = 6), isolated nonrotation of the duodenum (n = 2), partial rotation of the duodenum and colon (n = 1), partially rotated duodenum (n = 1) and isolated colonic partial rotation (n = 1). Four of these patients had accompanying complications, including volvulus (n = 2), right paraduodenal hernia (n = 1) and gastroduodenal intussusception (n = 1), respectively.

Conclusion

Imaging features of adult midgut malrotation are characteristic. Adult midgut malrotation has various manifestations, and types of midgut malrotation may be closely related to their complications.

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References

  1. Gamblin TC, Stephens RE, Johnson RK, Rothwell M. Adult malrotation: a case report and review of the literature. Curr Surg. 2003;60(5):517–20.

    Article  PubMed  Google Scholar 

  2. Kanazawa T, Kasugai K, Miyata M, Miyashita M, Mizuno M, Nagase F, et al. Midgut malrotation in adulthood. Intern Med. 2000;39(8):626–31.

    Article  PubMed  CAS  Google Scholar 

  3. Applegate KE, Anderson JM, Klatte EC. Intestinal malrotation in children: a problem-solving approach to the upper gastrointestinal series. Radiographics. 2006;26:1485–500.

    Article  PubMed  Google Scholar 

  4. Zissin R, Rathaus V, Oscadchy A, Kots E, Gayer G, Shapiro-Feinberg M. Intestinal malrotation as an incidental finding on CT in adults. Abdom Imaging. 1999;24(6):550–5.

    Article  PubMed  CAS  Google Scholar 

  5. Pickhardt PJ, Bhalla S. Intestinal malrotation in adolescents and adults: spectrum of clinical and imaging features. AJR. 2002;179:1429–35.

    Article  PubMed  Google Scholar 

  6. Moldrem AW, Papaconstantinou H, Broker H, Megison S, Jeyarajah DR. Late presentation of intestinal malrotation: an argument for elective repair. World J Surg. 2008;32(7):1426–31.

    Article  PubMed  Google Scholar 

  7. Strouse PJ. Disorders of intestinal rotation and fixation. Pediatr Radiol. 2004;34:837–51.

    Article  PubMed  Google Scholar 

  8. Long FR, Kramer SS, Markowitz RI, Taylor GE. Radiographic patterns of intestinal malrotation in children. Radiographics. 1996;16:547–56.

    PubMed  CAS  Google Scholar 

  9. Schey WL, Donaldson JS, Sty JR. Malrotation of bowel: variable patterns with different surgical considerations. Pediatr Surg. 1993;28:96–101.

    Article  CAS  Google Scholar 

  10. Torres AM, Ziegler MM. Malrotation of the intestine. World J Surg. 1993;17:326–31.

    Article  PubMed  CAS  Google Scholar 

  11. Inoue Y, Nakamura H. Aplasia or hypoplasia of the pancreatic uncinate process: comparison in patients with and patients without intestinal nonrotation. Radiology. 1997;205(2):531–3.

    PubMed  CAS  Google Scholar 

  12. Ditchfield MR, Hutson JM. Intestinal rotational abnormalities in polysplenia and asplenia syndromes. Pediatr Radiol. 1998;28:303–6.

    Article  PubMed  CAS  Google Scholar 

  13. Applegate KE, Goske MJ, Pierce G, Murphy D. Situs revisited: imaging of the heterotaxy syndrome. Radiographics. 1999;19:837–52.

    PubMed  CAS  Google Scholar 

  14. Shimanuki Y, Aihara T, Takano H, Moritani T, Oguma E, Kuroki H, Shibata A, et al. Clockwise whirlpool sign at color Doppler US: an objective and definite sign of midgut volvulus. Radiology. 1996;199(1):261–4.

    PubMed  CAS  Google Scholar 

  15. Okino Y, Kiyosue H, Mori H, Komatsu EJ, Matsumoto S, Yamada Y, et al. Root of the small-bowel mesentery: correlative anatomy and CT features of pathologic conditions. Radiographics. 2001;21:1475–90.

    PubMed  CAS  Google Scholar 

  16. Selçuk D, Kantarci F, Oğüt G, Korman U. Radiological evaluation of internal abdominal hernias. Turk J Gastroenterol. 2005;16(2):57–64.

    PubMed  Google Scholar 

  17. Martin LC, Merkle EM, Thompson WM. Review of internal hernias: radiographic and clinical findings. AJR. 2006;186:703–17.

    Article  PubMed  Google Scholar 

  18. Bartlett MK, Wang C, Williams WH. The surgical management of paraduodenal hernia. Ann Surg. 1968;2:249–54.

    Article  Google Scholar 

  19. Hsieh TM, Sheen-Chen SM, Lin CC. Combination of adult intussusception and intestinal malrotation: an unusual presentation. Dig Dis Sci. 2008;53(11):3037–9.

    Article  PubMed  Google Scholar 

  20. Gardner-Thorpe J, Hardwick RH, Carroll NR, Gibbs P, Jamieson NV, et al. Adult duodenal intussusception associated with congenital malrotation. World J Gastroenterol. 2007;13(28):3892–4.

    PubMed  CAS  Google Scholar 

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Radiology, Hangzhou First Municipal People’s Hospital, Affiliated Hangzhou Hospital of Nanjing Medical University, Hangzhou, Zhejiang, 310006, China

    Bin Yang & Wen-Hui Chen

  2. Department of Gastroenterology, Hangzhou First Municipal People’s Hospital, Affiliated Hangzhou Hospital of Nanjing Medical University, Hangzhou, Zhejiang, 310006, China

    Xiao-Feng Zhang

  3. Department of General Surgery, Hangzhou First Municipal People’s Hospital, Affiliated Hangzhou Hospital of Nanjing Medical University, Hangzhou, Zhejiang, 310006, China

    Zhong-Rao Luo

Authors
  1. Bin Yang
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  2. Wen-Hui Chen
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  3. Xiao-Feng Zhang
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  4. Zhong-Rao Luo
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Corresponding author

Correspondence to Bin Yang.

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Yang, B., Chen, WH., Zhang, XF. et al. Adult midgut malrotation: multi-detector computed tomography (MDCT) findings of 14 cases. Jpn J Radiol 31, 328–335 (2013). https://doi.org/10.1007/s11604-013-0194-8

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  • DOI: https://doi.org/10.1007/s11604-013-0194-8

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