The Diagnostic Value of Ultrasonography in Pediatric Intestinal Malrotation

Background & objectives Intestinal malrotation is a congenital disorder, which is characterized by defects in the natural rotational process of intestinal loops. This anomaly is considered important due to its acute and chronic presentations. This study was designed to investigate the diagnostic value of ultrasonographic findings in patients with suspected intestinal malrotation. Materials & methods In this prospective, cross-sectional study, performed at Dr. Sheikh Pediatric Hospital of Mashhad during 2009-2014, sixty patients (less than 15 years of age) were selected via purposive sampling. The subjects were suspected of having intestinal malrotation, based on upper gastrointestinal findings, surgical manifestations or study the diagnostic accuracy of ultrasound in a group of patients with the inclusion criteria of ultrasonographic features of malrotation (i. e. , abnormal pathway of mesenteric vessels such as the inversion of mesenteric vessels, duplication of the superior mesenteric vein, anterior position of mesenteric vein relative to superior mesenteric artery and whirlpool sign). Results Among 60 patients, 31 (51.7 %) were male, with a median age of 2.81.3 years. The most common symptoms were vomiting (45 %) and chronic abdominal pain (21.6 %), respectively. The rate of associated anomalies was 51.6 % and volvulus was reported in 6.6 % of patients. Overall, ultrasound evaluations had a sensitivity of 82 % in comparison with surgical findings. Conclusion Based on the findings, ultrasonography of mesenteric vessels is a sensitive diagnostic tool for the detection of intestinal rotational disorders in pediatric populations. Therefore, abnormal ultrasonographic findings should be taken into consideration in suspected patients.