Infant with bilious vomiting and abdominal distension

UGI of false positive malrotation with midgut volvulus — AXR upright (left) shows multiple dilated loops of small bowel with air fluid levels. Sagittal US of the abdomen (above right) shows multiple dilated loops of peristalsing small bowel, however an intussusception was not seen. AP image from an upper GI exam (below right) shows the duodenal-jejunal junction to be low in position and to be to the right of the spine.

The diagnosis was Meckel diverticulum causing a small bowel obstruction and a false positive diagnosis of malrotation with midgut volvulus due to displacement of the duodenal-jejunal junction by dilated loops of small bowel.