How Useful is Ultrasound in the Imaging Workup of Malrotation?


Ali Reza Khatami 2 , * , Kiarash Mahdavi 1

2 Department of Radiology, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran

1 Department of Radiology, Mofid Childrens Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran

How to Cite: Reza Khatami A, Mahdavi K. How Useful is Ultrasound in the Imaging Workup of Malrotation?, Iran J Radiol. Online ahead of Print ; 11(30th Iranian Congress of Radiology):e21395. doi: 10.5812/iranjradiol.21395.


Iranian Journal of Radiology: 11 (30th Iranian Congress of Radiology); e21395
Published Online: February 28, 2014
Article Type: Research Article


Background: The position of third portion of duodenum (D3) is always intramesenteric in malrotation. Displaying normal retromesenteric- retroperitoneal position of D3 by ultrasound (US) can help to rule out malrotation.

Objectives: The aim of this study was to evaluate the feasibility of US in demonstration of retroperitoneal D3.

Patients and Methods: Abdominal US study was performed for various indications in sixty newborns and infants [Mean age: 33 days (range: 4-100 days); 56.7% male] by an expert paediatric radiologist. D3 position and its adjacent structures were evaluated in axial and longitudinal planes by linear and curve transducers.

Results: Normal retromesenteric-retroperitoneal D3 between superior mesenteric artery and aorta was seen by US in all patients, including those with severe bowel gas. Mean time for displaying D3 was 47.8 s (10-180 s). Ultrasound was also capable to demonstrate D3 structure, diameter, content, its adjacent structures, relative position of superior mesenteric artery and vein.

Conclusions: Ultrasound is a simple, fast and highly accurate modality for confirming retroperitoneal position of D3. Ultrasound can be used as the screening method for malrotation and obviate unnecessary barium studies.

© 2014, Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.

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