DUODENUM AND DUODENAL-JEJUNAL JUNCTION IN CHILDREN - POSITION AND APPEARANCE AFTER LIVER-TRANSPLANTATION

PURPOSE: TO correlate upper gastrointestinal study findings of the pos ition of the duodenum and duodenal-jejunal junction in children after liver transplantation with transplant type, age at transplantation, in dication:for transplantation,: and history of surgery or malrotation. MATERIALS AND METHODS: Upper gastrointestinal studies in 23 children w ith a liver transplant were reviewed by two pediatric radiologists and appearance-and position of the duodenum and duodenal-jejunal junction were recorded. Findings were correlated with transplant type, age at transplantation, indication for transplantation, and history of surger y or malrotation. RESULTS: The duodenum and duodenal-jejunal junction were visualized on anteroposterior spot radiographs in 18 children. In 10 children, the duodenum-and the junction were elevated and to the r ight of the spine; in two, the first and second portions of the duoden um were elevated, but the junction was normally located. These 12 chil dren had undergone segmental liver transplantation. in the remaining s ix children, the duodenum and junction were normally positioned; three of these children had a whole liver transplant, and three had a segme ntal transplant. CONCLUSION: The duodenum and duodenal-jejunal junctio n are often malpositioned in children with a left lobe or left lateral segmental liver transplant. Without documented bowel obstruction, how ever, these children should be observed and followed up clinically.