Adult midgut malrotation: multi-detector computed tomography (MDCT) findings of 14 cases

Abstract

To describe MDCT findings in adult patients of midgut malrotation and to correlate the types of adult midgut malrotation with its complications. CT scans were performed on 14 adult patients with midgut malrotation. The images were reviewed retrospectively by one radiologist. Abnormal intestinal location, mesenteric vascular arrangement, extraintestinal anomalies and complications were evaluated and correlated with patterns of adult midgut malrotation. The 14 cases of adult midgut malrotation revealed the following CT findings: intestinal malposition (n = 14), abnormally oriented mesenteric vessels (n = 8), extraintestinal anomalies (n = 14). These cases were classified into six types: complete nonrotation (n = 3), nonrotated duodenum and partially rotated colon (n = 6), isolated nonrotation of the duodenum (n = 2), partial rotation of the duodenum and colon (n = 1), partially rotated duodenum (n = 1) and isolated colonic partial rotation (n = 1). Four of these patients had accompanying complications, including volvulus (n = 2), right paraduodenal hernia (n = 1) and gastroduodenal intussusception (n = 1), respectively. Imaging features of adult midgut malrotation are characteristic. Adult midgut malrotation has various manifestations, and types of midgut malrotation may be closely related to their complications.