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Age: 1 week (born at 35 weeks)

Sex: Male

Indication: Feeding difficulty

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Case #5


Findings

  • Enteric tube tip overlies the stomach
  • Gaseous distension of the stomach with a paucity of small and large bowel gas
  • No evidence of free intraperitoneal air
  • No abnormal intraabdominal mass effect or calcification
  • No acute findings in the chest


Diagnosis

  • Midgut volvulus

Sample Report

Enteric tube tip overlies the stomach.

Gaseous distension of the stomach with a paucity of small and large bowel gas. Findings are concerning for a partial proximal small bowel or gastric outlet obstruction. Recommend upper GI series for further evaluation.

No evidence of free intraperitoneal air.

No abnormal intraabdominal mass effect or calcification.

No acute findings in the chest.


Discussion

  • This is a good example of a proximal small bowel obstruction on radiographs
  • Remember that midgut volvulus and malrotation usually go hand-in-hand


Images

Upper GI series in this patient shows a distended proximal duodenum with a corkscrew appearance of the distal duodenum (red arrow), which is malrotated.

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