Upper gastrointestinal series are frequently obtained on children with
abdominal pain and vomiting, If the ligament of Treitz (LOT) is in an
equivocal position and not to the left of the spine at L1 or L2 it is
important to determine the position and fixation of the cecum to asse
ss the breadth of the mesenteric pedicle, Radiographic studies may not
accurately accomplish this because of the changing position of the ce
cum, Laparoscopy can be used to determine the position of LOT and whet
her the cecum is fixed in the right lower quadrant, If the patient is
judged to be at risk for volvulus (i,e,, a shortened mesenteric pedicl
e) a Ladd's procedure can be accomplished laparoscopically with good l
ong-term results, The use of the laparoscope is not advocated when acu
te volvulus is suspected.