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Color Doppler—An effective tool for diagnosing midgut volvulus with malrotation

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Abstract

Background

Malrotation with midgut volvulus is a common surgical emergency in children. A diagnostic tool for malrotation with characteristics ideal in emergency settings such as non-invasiveness and rapidity remains a keenly debated issue among surgeons and radiologists alike.

Methods

Fifty-two pediatric patients of suspected malrotation with midgut volvulus were studied between 1998 and 2016. All patients underwent plain abdominal X-ray and Color Doppler; contrast upper gastrointestinal (GI) studywas done in some patients. All cases were operated and diagnosis was confirmed. A subset of 60 pediatric patients with nonspecific GI complaints were also examined to see relative position of superior mesenteric vein (SMV)/superior mesenteric artery (SMA) in control population.

Result

A total of 52 suspected cases of malrotation were admitted from May 1998 to November 2015, 43 had inversion of SMA/SMV and nine had SMV anterior of SMA in Color Doppler. All 43 cases of inversion of SMA/SMV were cases of malrotation after surgical confirmation; while five out of nine cases of SMV anterior to SMA had malrotation.

Conclusion

In appropriate clinical settings, Color Doppler documenting the reversal or aberrant SMV/SMA axis is not only predictive but also diagnostic of malrotation of gut.

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Acknowledgement

Authors acknowledge the contribution of Dr. Alok Ranjan, Asst Prof, Dept of CFM, AIIMS, Patna in the statistical analysis of data.

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Authors and Affiliations

  1. Department of Pediatric Surgery, All India Institute of Medical Sciences, Phulwari Sharif, Patna, 801 507, India

    Bindey Kumar & Amit Kumar Sinha

  2. Department of Pediatrics, All India Institute of Medical Sciences, Phulwari Sharif, Patna, 801 507, India

    Manish Kumar

  3. Department of Radiology, All India Institute of Medical Sciences, Phulwari Sharif, Patna, 801 507, India

    Prem Kumar

  4. Department of Gastrosurgery, Indira Gandhi Institute of Medical Sciences, Sheikhpura, Patna, 800 014, India

    Utpal Anand

  5. Department of Surgery, All India Institute of Medical Sciences, Phulwari Sharif, Patna, 801 507, India

    Anil Kumar

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  1. Bindey Kumar
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  2. Manish Kumar
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  3. Prem Kumar
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  4. Amit Kumar Sinha
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Correspondence to Manish Kumar.

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Conflict of interest

BK, MK, PK, AKS, UA, and AK  declare that they have no conflict of interest.

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The authors declare that the study was performed in a manner to conform to the Helsinki declaration of 1975, as revised in 2000 and 2008 concerning human and animal rights, and the authors followed the policy concerning informed consent as shown on Springer.com.

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Kumar, B., Kumar, M., Kumar, P. et al. Color Doppler—An effective tool for diagnosing midgut volvulus with malrotation. Indian J Gastroenterol 36, 27–31 (2017). https://doi.org/10.1007/s12664-017-0729-5

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  • DOI: https://doi.org/10.1007/s12664-017-0729-5

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