[The diagnostic performance of color Doppler ultrasonography for newborn four cases of midgut volvulus accompanied by intestinal malrotation]

Yukari Ikeshima, Katsuya Hisano, Takeshi Morisawa, Kozue Inoue, Masahiro Shimamoto, Toshiaki Koujitani, Masahiko Yonetani, Masao Yasufuku
Rinsho Byori. the Japanese Journal of Clinical Pathology 2014, 62 (3): 231-4
Midgut volvulus accompanied by intestinal malrotation is classified as a surgical emergency disease of the newborn, which emerges with the bilious vomiting or melena. This report presents four patients of this disease in our hospital, evaluated by color Doppler ultrasonography before surgical operation. All four patients were presented by bilious vomiting at the onset. By color Doppler ultrasonography method, the whirlpool sign which is the view of intestine and superior mesenteric vein rotated around with the axis of superior mesenteric artery, were shown in all cases. This whirlpool sign led to the diagnosis of midgut volvulus accompanied by intestinal malrotation. Intestinal contrast imaging was tested in three patients for the purpose of confirming the diagnosis. Repair of the volvulus and a ladd operation was performed in all four patients, without the excision of intestine because of no intestinal ischemic change. The clinical courses of four cases were good, and all patients were discharged within 17 days. Early diagnosis and timely surgical operation are essential for decreasing the possibility of occurring intestinal ischemic changes and improving clinical outcome after surgical operation. We propose that color Doppler ultrasonography is the powerful tool for the diagnosis of this disease, especially for the newborn, for whom the available diagnostic tests are limited.

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