A Pediatric Radiology textbook and Pediatric Radiology digital library
Malrotation Without Midgut Volvulus
Etiology: abnormal rotation of the gut as it returns to the abdominal cavity during embryogenesis
AXR: usually unremarkable
UGI: Duodenal-jejunal junction (ligament of Treitz) is where retroperitoneal duodenum comes out into peritoneum and it needs to be over left pedicle of spine or to left of spine and to be at level of duodenal bulb and failure to meet both of these criteria results in diagnosis of malrotation, small intestine in right side of abdomen and colon in left side of abdomen
Treatment: Ladd’s procedure
Cases of Malrotation Without Midgut Volvulus
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.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.