PAEDIATRICS
MALROTATION AND VOLVULUS
PromptHistory
ResponseTypically, the neonate is entirely normal for a period and then suddenly presents with bilious vomiting. - radiopaedia
Bilious vomiting
May have normal abdominal examination, distension is a late sign
Shock (late sign)
Unless the volvulus is reduced (or reduces spontaneously), the superior mesenteric vein wrapped around the superior mesenteric artery causes progressive venous obstruction, gradual onset of ischemia, and eventual necrosis.
Bilious vomiting
May have normal abdominal examination, distension is a late sign
Shock (late sign)
Unless the volvulus is reduced (or reduces spontaneously), the superior mesenteric vein wrapped around the superior mesenteric artery causes progressive venous obstruction, gradual onset of ischemia, and eventual necrosis.
PromptInvestigations
ResponseUS - duodenal distension, dilated loops of bowel (r side)
XR - “Double bubble” sign (Also in duodenal atresia)
XR - “Double bubble” sign (Also in duodenal atresia)