Pitfalls in the radiological diagnosis of malrotation
Beasley, S.W.; de Campo, J.F.
Australasian Radiology 31(4): 376-383
1987
ISSN/ISBN: 0004-8461 PMID: 3453049 Document Number: 295139
Accurate diagnosis of malrotation is essential if the catastrophic effects of volvulus are to be avoided. A review was conducted of 32 patients with operatively proven malrotation to evaluate the use of contrast in the pre-operative diagnosis. Of the 28 with adequate barium study(s), two had false negative barium meals and two had false negative barium enemas. Two further cases in whom malrotation was diagnosed on barium meal but in whom no malrotation was found at laparotomy are described. Problems relating to technique and interpretation, and refinements which may be expected to reduce the likelihood of error using the barium meal and enema are discused. An abnormally positioned duodeno-jejunal (D-J) flexure is the most reliable sign of malrotation and should be identified routinely in any child having an upper gastro-intestinal contrast study, whatever their symptoms.