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Midgut Volvulus

KEY FACTS Terminology Ligament of Treitz: Suspends duodenojejunal junction (DJJ), defines normal duodenal rotation Malrotation: Abnormal rotation & fixation of small bowel (SB) mesentery that can lead to complications Bowel obstruction by Ladd bands Midgut volvulus (MV) due to short mesenteric base, prone to twisting MV: Twisting of SB about superior mesenteric artery → bowel obstruction, ischemia/necrosis Imaging Radiographs: Most common appearance is normal Distended stomach…

Malrotation

KEY FACTS Terminology Malrotation: Any abnormal rotation of small or large bowel, which rotate separately during development Malfixation: Abnormal position or length of bowel fixation by mesentery, typically associated with malrotation Short mesenteric fixation predisposes to midgut volvulus [twisting of midgut about superior mesenteric artery (SMA) → vascular occlusion & potential bowel ischemia] Imaging Fluoroscopic GI findings 3rd duodenum (D3) never crosses midline, often extends anteriorly…

Kawasaki Disease

KEY FACTS Terminology Inflammatory disease of small- & medium-sized blood vessels of unknown etiology, mainly in young children Widespread but characteristic manifestations Coronary artery aneurysms most feared complication Imaging Chest radiography usually normal Echocardiography has sufficient sensitivity & specificity in detecting proximal coronary artery aneurysms Remains 1st-line modality CTA can demonstrate aneurysms, stenoses, & Ca²⁺ of coronary or other arteries Cardiac MR protocol includes function, coronary…

Heterotaxy Syndromes

KEY FACTS Terminology Disturbance of normal left-right asymmetry in position of thoracic & abdominal organs; typically described in terms of right atrial isomerism vs. left atrial isomerism Imaging Best diagnostic clue: Abnormal symmetry in chest & abdomen Classic radiographic appearance: Transverse midline liver, discrepancy between position of cardiac apex & stomach, bilateral left- or right-sidedness in chest, cardiomegaly or other findings of congenital heart disease Echo:…