Midgut volvulus

Discussion:

Contrast has been administered via a nasogastric tube to a child who presents with acute onset of bilious vomiting and abdominal pain.

It passes from the stomach into the duodenum. 

The DJ flexure should usually be located to the left of midline at the level of the duodenal cap. Here it is not, indicating that there is malrotation.

The lumen is narrowed and passes directly inferiorly in a corkscrew pattern. Findings are of midgut volvulus secondary to intestinal malrotation.

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