RADIOGRAPHIC PATTERNS OF INTESTINAL MALROTATION IN CHILDREN

Intestinal malrotation is a major diagnostic challenge in children, So metimes the prognostic significance of the findings from upper gastroi ntestinal tract examinations is unclear, In a series of 69 surgically proved cases, the authors studied the prevalence and clinical conseque nces of various radiographic patterns of malrotation and correlated su rgical findings with the radiographic location of the duodenum and cec um, Seven patterns of duodenal malrotation were observed, Almost all c hildren in the series had abnormalities of rotation or fixation of bot h the duodenum and colon, resulting in narrowing of the mesenteric bas e with potential for midgut volvulus, Of 69 patients, only one (1.4%) had an anatomically normal duodenum, and four (5.8%) had a surgically confirmed normal cecum fixed in the right lower quadrant, In the absen ce of a corkscrew or Z-shaped duodenum, patterns that usually indicate volvulus or obstructing Ladd bands, colon position had greater progno stic implication, especially when the cecum was situated in the right upper quadrant or left upper quadrant, These latter patterns were asso ciated with the highest prevalence of volvulus.