Value of ultrasound in the diagnosis of congenital intestinal malrotation and midgut vovulus

Objective To evaluate the value of ultrasound in the diagnosis of congenital intestinal malrotation and midgut vovulus.Methods The findings of ultrasound of 161 children with clinically suspected intestinal malrotation were analysed retrospectively,and were compared with the results of the operation and/or the upper gastrointestinal contrast study.Results The positive sign of ultrasound for congenital intestinal malrotation was that the superior mesenteric vein(SMV) being located at the left of the superior mesentery artery(SMA),or being directly anterior to the SMA,and the positive sign for midgut vovulus was clockwise whirlpool sign (clockwise rotation of the small bowel,its mesentery and the SMV around the SMA).The sensitivity of ultrasound for congenital intestinal malrotation was 82％,and the specificity was 94％.Those for midgut vovulus were 94％ and 94％ respectively.Conclusions Special sign as the superior mesenteric vein(SMV) being located at the left of the superior mesentery artery(SMA) strongly indicate congenital intestinal malrotatione,and the clockwise whirlpool sign means great possibility of midgut vovulus. Key words: Ultrasonography; Intestinal vovulus; Congenital intestinal malrotation