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Malrotation. A, Transverse color Doppler image of the mesenteric vessels in a 3-week-old boy presenting with vomiting. A normal position of the SMV is seen to the right of the SMA. C and D, Transverse gray-scale (B) and color Doppler (C and D) images of the mesenteric vessels in a 3-week-old boy presenting with bilious vomiting. On the gray-scale image, the SMV is no longer seen in its normal position to the right of the SMA but is anterior to it, even crossing over to the left. On the color Doppler images, the ''whirlpool sign'' is demonstrated with the SMV swirling around the SMA, indicative for malrotation complicated by volvulus.  

Malrotation. A, Transverse color Doppler image of the mesenteric vessels in a 3-week-old boy presenting with vomiting. A normal position of the SMV is seen to the right of the SMA. C and D, Transverse gray-scale (B) and color Doppler (C and D) images of the mesenteric vessels in a 3-week-old boy presenting with bilious vomiting. On the gray-scale image, the SMV is no longer seen in its normal position to the right of the SMA but is anterior to it, even crossing over to the left. On the color Doppler images, the ''whirlpool sign'' is demonstrated with the SMV swirling around the SMA, indicative for malrotation complicated by volvulus.  

Context in source publication

Context 1
... vein (SMV). The SMV is then located to the left of the artery, which is the opposite of its usual orientation. Associated features are duodenal dilatation with distal tapering, duodenal wall thickened over 2 mm, fixed midline bowel, ascites, the whirl- pool sign (when the SMV and its tributaries swirl around the SMA in clockwise direction) (Figs. 3 and 4), 8 and dilata- tion of the distal SMV. 9 The distal SMV (measured below the umbilical level) is considered dilated if its diameter is greater than that of the proximal SMV (measured above the umbilical level). Water instillation into the bowel can be a helpful trick to better evaluate the duodenal configuration and in particu- lar to ...

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