Ultrasound for malrotation and volvulus — point

Youssfi, Mostafa; Gonçalves, Luís F.

doi:10.1007/s00247-021-05154-0

Cited by 12 publications

(6 citation statements)

References 37 publications

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“…[ 16 ] However, the abnormal position of the SMV is not completely diagnostic, as some patients with malrotation may have a normal positional relationship, while patients without malrotation may also have a vertical or inverted relationship. [ 20 ] Therefore, when CT shows an abnormal relationship of the mesenteric vessels, it is necessary to carefully evaluate whether there is an abnormal intestinal position. Third, the uncinate process was hypoplastic (Fig.…”

Section: Discussionmentioning

confidence: 99%

Midgut malrotation presenting with hyperemesis gravidarum: A case report

Zhao

Yang

et al. 2022

Medicine

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Rationale: Midgut malrotation is a rare congenital abnormality resulting from failure of complete intestinal rotation and subsequent fixation during early fetal development. There appeared to be no obvious symptoms in most patients, and a few patients may exhibit symptoms similar to hyperemesis gravidarum, such as nausea and vomiting. Here, we present a case of midgut malrotation presenting as hyperemesis gravidarum.Patient concerns: A 27-year-old woman with an intrauterine pregnancy of 27 + 6 weeks complained of severe nausea and vomiting for 2 weeks.Diagnosis: Magnetic resonance imaging showed obvious dilatation in the proximal part of the duodenum and gastric cavity and the absence of a duodenal path dorsal to the superior mesenteric artery, which was diagnosed as midgut malrotation.Interventions: Considering that the patient's vital signs were stable, without manifestation of peritonitis or the risks of surgery to the fetus, conservative treatment was adopted. Unfortunately, the fetus developed severe hydrocephalus at 32 weeks. The patient and her family decided to abandon the fetus, and a mid-trimester-induced abortion was performed.Outcomes: The related symptoms completely disappeared after delivery, and the relevant examination after discharge also confirmed the presence of midgut malrotation without gastrointestinal discomfort within 1 year after delivery.Lessons: Midgut malrotation can be considered as a differential diagnosis of hyperemesis gravidarum. Conservative treatment under close monitoring is desirable in pregnant women diagnosed with midgut malrotation.

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Section: Discussionmentioning

confidence: 99%

Midgut malrotation presenting with hyperemesis gravidarum: A case report

Zhao

Yang

et al. 2022

Medicine

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“…Steht die Vene nicht bei "11 Uhr" in Relation zur Arterie, besteht der dringende Verdacht auf eine Rotationsstörung (▶ Abb. 2c) [14]. Verfolgen Sie diese Gefäße dann nach kaudal, findet sich im Falle eines Volvulus das typische "Whirlpool-Sign" mit Verdrehung der Vene um die Arterie.…”

Section: Neugeborene Und Säuglingeunclassified

“…If the vein is not in the 11 oʼclock position in relation to the artery, there is urgent suspicion of a disorder of intestinal rotation (▶ Fig. 2c) [14]. If you follow these vessels caudally, the typical whirlpool sign with twisting of the vein around the artery can be ▶ Table 1 Common causes of acute abdominal pain in children and adolescents in the different age groups.…”

Section: Notementioning

confidence: 99%

Acute care diagnostics in children for general radiologists – not alone in the hospital at night

Beer

Mentzel

Steinborn

et al. 2022

Rofo

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Background Radiologic care for children and adolescents during night and weekend shifts is challenging. This is especially true when a dedicated pediatric radiology front or background service is not available. Methods The purpose of this review is to present the approach, the most relevant diagnoses, and their differential diagnoses based on four common example cases – abdominal pain, respiratory/chest pain, headache, and refusal to walk. Essentials such as clinical classification (e. g., disease dynamics) and practical instructions (e. g., necessity of acute cross-sectional imaging) are presented. Results and Conclusion For the abdomen, appendicitis ranks first among acute diseases. Other important diseases are intussusception and volvulus. Far more frequently, however, gastroenteritis is the cause of abdominal pain. Usually no imaging is required in this case. In unclear clinical situations, ultrasound may be indicated. In suspected pulmonary infections, chest imaging is limited to inconclusive cases and suspicion of complications such as pleural empyema. Major emergencies include (spontaneous) pneumothorax and aspiration. Headache is a common symptom. Immediate imaging is only necessary in cases of suspected acute inflammatory (meningitis/encephalitis) or vascular disease (e. g., hemorrhage due to vascular malformations). MRI is the primary imaging modality in these cases. Restricted walking/refusal to walk is a classic nonspecific sign, particularly of acute musculoskeletal disease, especially in younger children. Clinical examination is essential to narrow down the field of investigation. Besides the frequent and symptomatic coxitis fugax, the rare but serious (septic) arthritis/osteomyelitis must not be overlooked. Key Points: Citation Format

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“…However, the sample size of these studies is small; thus, the results can't be generalized. (4,6)This study evaluates the diagnostic accuracy and safety of ultrasonography for intestinal malrotation in pediatric patients.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Accuracy and Safety of Ultrasonography for Intestinal Malrotation in the Pediatric Population

HANIF,

SIDDIQUE,

GORAYA

et al. 2024

Biol Clin Sci Res J

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Intestinal malrotation is a critical condition in pediatric patients that requires accurate and timely diagnosis. Ultrasonography is a non-invasive imaging modality frequently used to diagnose this condition. Objective: To evaluate ultrasonography's diagnostic accuracy and safety for detecting intestinal malrotation in pediatric patients. Methods: This retrospective study was conducted at Lahore General Hospital from January 2023 to January 2024. The study included children who underwent ultrasound for suspected malrotation during this period. Ultrasounds were performed by pediatric sonographers and interpreted by radiologists. The ultrasound examination was deemed indeterminate if normal anatomy was not delineated or the diagnosis was not confirmed. Data were analyzed to determine the sensitivity and specificity of ultrasonography in diagnosing intestinal malrotation. Results: Ultrasound examinations were performed on 230 patients for suspected malrotation. The mean age of the participants was 1.4 years. Among these, 61.7% (142) were neonates, with 36% (51/142) presenting on the first day of life. 218 (94.7%) patients had normal ultrasound findings, with no false-negative results reported. Malrotation was diagnosed through ultrasound in 7 (3%) patients, two of whom had associated malrotation. Five out of these seven patients were neonates. No false-positive results were reported after surgical confirmation. Additionally, 5 (2.17%) patients had indeterminate ultrasound findings. The sensitivity and specificity of ultrasonography for diagnosing intestinal malrotation were 100%. Conclusion: The study concludes that ultrasonography is a safe, accurate, and effective diagnostic tool for intestinal malrotation in pediatric patients. It is a feasible option for clinical practice due to its high diagnostic accuracy and non-invasive nature.

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Ultrasound for malrotation and volvulus — point

Cited by 12 publications

References 37 publications

Midgut malrotation presenting with hyperemesis gravidarum: A case report

Midgut malrotation presenting with hyperemesis gravidarum: A case report

Acute care diagnostics in children for general radiologists – not alone in the hospital at night

Diagnostic Accuracy and Safety of Ultrasonography for Intestinal Malrotation in the Pediatric Population

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