School ager with heterotaxy syndrome and asplenia and bilious vomiting

CXR of heterotaxy syndrome and upper GI of malrotation without midgut volvulus
CXR AP (above) shows the cardiac apex to be in the right hemithorax and the gastric bubble to be in the left upper quadrant. AP image from an upper GI (below) 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.

The diagnosis was malrotation without midgut volvulus in a patient with heterotaxy syndrome.