Possibilities of ultrasonography in diagnosis of intestinal malrotation: our own experience and literature review
DOI:
https://doi.org/10.15574/PS.2018.60.66Keywords:
ultrasonography, intestinal malrotation, childrenAbstract
Intestinal malorotation joints a wide range of congenital anomalies of rotation and fixation of the intestine, and late diagnosis of this defect can lead to the life-threatening complications, especially in young children. Radiographic contrast study of the gastrointestinal tract (GIT) in some patients does not provide convincing data on the presence/absence of malrotation, which requires the use of other examination methods, including ultrasound.
Objective: to compare the results of our experience of ultrasound examination (US) in children with intestinal malrotation without clinical signs of intestine torsion with literature data concerning this pathology.
Results. The diagnosis of malrotation in two children aged 1.5 months and 3 years was confirmed during the surgical intervention as the X-ray examination of GIT did not allow an accurate diagnosis. However, the US with color flow mapping (CFM) revealed an inversion of the superior mesenteric vessels and a positive «whirlpool» sign, which, according to the literature data, are typical for intestinal malrotation. Unlike other researchers who consider the positive «whirlpool» sign as a characteristic feature of the midgut volvulus, the symptom was found in the children without any manifestations of malrotation.
Conclusions. Ultrasound examination is an efficient method of diagnosis in paediatric patients suspected of malorotation. The revealed inversion of the mesenteric vessels and the «whirlpool» sign in the ultrasound examination is indicative of the malorotation, even in lack of the midgut volvulus clinical evidences.
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