Sonographic evaluation of superior mesenteric vascular relationship in malrotation

Abstract

We report sonographic demonstration of abnormal and characteristic superior mesenteric vascular anatomy in three cases of surgically proved intestinal malrotation. Sonographic screening examinations of children with abdominal pain should include an evaluation of the superior mesenteric vessels.

A Case of Choledocholithiasis and Intestinal Malrotation in an Adolescent with Repaired Gastroschisis

“…Findings included the absence of the retroperitoneal duodenum,9 an abnormal relationship between the superior mesenteric vein and superior mesenteric artery,10,11 a right-sided duodenojejunal flexure, and malpositioning of the bowel 11. Intestinal malrotation can induce or potentiate biliary stasis by causing contraction or compression of the biliary tract and displacement of the duodenum 5,12.…”

Computed tomography in the diagnosis of adult midgut rotational anomalies: A report of two cases

“…However, the situation is different in asymptomatic adults or those with nonrelated clinical manifestations, in whom the index of suspicion of a congenital lesion may be low, and, hence, a barium meal study may not be done. CT scan, angiography, and US have all been reported to have facilitated the recognition of these anomalies, [2][3][4][5][6][7][8][9][10][11][12][21][22][23][24] with the CT scan being the most rapid, non-invasive diagnostic tool.…”

“…A Medline computer search up to 1996 showed only four reported cases of colonic malignancies associated with intestinal malrotation. 1,[17][18][19] The rotational anomalies were recognized in only one rior mesenteric vascular anatomy has been reported to be helpful in pediatric cases of intestinal malrotation and volvulus, 11,12,23,24 it has the disadvantage of being operator-dependent, and we can find no reports of its use in adults. In midgut volvulus, not only the intestine but also the mesenteric vessels are volvulated.…”

Intestinal malrotation – volvulus: Imaging findings

“…2,3,6,23 Instead in the malrotation of the vein it can usually be found to the left of the artery, 2,6,16 yet it is not a sign specific or sensitive enough to be able to diagnose malrotation; the association of inverted SMA/SMV has been reported in patients with normal rotation and 30% of patients show malrotation and a normal SMA/SMV relation. 2,6,23,29,30 Diagnostic sensitivity is even lower when the SMV is located right ahead of the SMA 26,31,32 (Fig. 9A).…”