Aspectos embriológicos, clínicos y radiológicos de la malrotación intestinal

Intestinal malrotation with its propensity to volvulus represents a diagnostic challenge in pediatric patients. Early diagnosis is of extreme importance for achieving a good outcome. This article reviews and illustrates the radiologic findings for malrotation and volvulus of the small bowel in childhood and adolescence. The embryology, clinical presentation, radiologic management, and evolution of this process are discussed. The diagnosis of malrotation and volvulus should be considered whenever a nursing baby or child presents with vomiting and abdominal pain, especially if the vomit is bilious. A barium follow-through usually provides the diagnosis. Ultrasound is very useful, although it cannot safely rule out the diagnosis. However, the “whirlpool sign” is a highly sensitive sign for the diagnosis of small bowel volvulus. The radiologist needs to bear in mind that this complication can occur at any age.