Diagnostic function of ultrasonography in malrotation of intestine with midgut volvulus

Abstract

Objective Malrotation of intestine with midgut volvulus is a special disease in newborns.It is important of early diagnosis to avoid the risk of intestinal infarct and necrosis.We intended to explore the value of early ultrasonographic diagnosis in malrotation of intestine with midgut volvulus, comparing with upper gastrointestinal imaging. Methods Ultrasonographic features and upper gastrointestinal imaging of 48 surgically confirmed malrotation of intestine with midgut volvulus between January 2011 and December 2014 were retrospectively analyzed. Results All patients were comfirmed by operaion.The rotational degree of midgut volvulus were 90 to 720°.In 43 of 48 patients(89.58%)of malrotation of intestine with midgut volvulus were diagnosed by ultrasonography.The typical ultrasonographic features were calledwhirlpool sign, which was the superior mesenteric vein and the mesentery around the superior mesenteric artery.In 35 of 48(72.92%)patients with malrotation were confirmed by the upper gastrointestinal imaging.The typical sign of the upper gastrointestinal imaging was the helical form of the distal duodenum and proximal jejunum located at middle abdomen.Compared with upper gastrointestinal radiographic examination, ultrasonographic examination had more sensitivity in diagnosis of malrotation of intestine with midgut volvulus(P<0.05). Conclusion Ultrasonographic examination have more sensitivity in diagnosis.Noninvasiveness, absence of X-rays, and low costs could make ultrasonographic examination a useful screening test in patients with suspected malrotation of intestine with midgut volvulus.Whirlpool signcould be considered a specific ultrasonographic sign in diagnosis of midgut volvulus, which could provide reference for the clinical treatment of malrotation of intestine with midgut volvulus. Key words: Ultrasonography; Malrotation; Midgut volvulus