Answer of April 1999

Clinical History:

3 days old boy with repeated bilious vomiting after birth.

Figure 1 Barium meal(LPO).
Figure 2 Barium meal (focal LPO).

What is your diagnosis?

                           Figure 1                                                                    Figure 2

Diagnosis:

Midgut volvulus

Discussion:

Figure 1 Barium meal shows dilated somach and abnormal cockscrew apperance of the midgut bowel loops.

Figure 2 Barium meal with a more localised view which better demontrates the spiral course of the midgut small bowel loops.This cockscrew apperance is diagnostic of midgut volvulus comfirmed at surgery.