Infant with heterotaxy syndrome and complex congenital heart disease and bilious vomiting AP image from an upper GI shows the ligament of Treitz to be in the right upper quadrant. There is no evidence of duodenal obstruction. The proximal jejunum is also in the right upper quadrant. There is also gastroesophageal reflux. The diagnosis was malrotation without midgut volvulus in a patient with heterotaxy syndrome.