EP07.52: Study on the ultrasound diagnosis of congenital intestinal malrotation and volvulus

To explore the value of prenatal and neonatal ultrasound in the diagnosis of congenital intestinal malrotation and volvulus. Review the ultrasound examinations of 6 cases of congenital intestinal malrotation and volvulus confirmed by surgery after birth in Nanjing Maternity and Child Health Care Hospital from 2021 to 2023, and analyse their ultrasound imaging characteristics. The ultrasound features of the 6 cases were as follows: 1 case of intestinal malrotation and midgut volvulus with clockwise torsion at about 540°, prenatal ultrasound revealed slight dilation of the intestinal tract. Ultrasound after birth revealed scattered echoes between the tracts, duodenal dilation, abdominal fluid accumulation, and punctate strong echoes between the intestinal walls; 1 case with clockwise rotation at 180°, US after birth revealed an mass at the root of the superior mesenteric artery, with the superior mesenteric vein rotating clockwise around the superior mesenteric artery; 1 case at about 360°clockwise rotation, US revealed the SMV rotating anticlockwise around the SMA; 1 case with clockwise rotation about 540°, US revealed extensive intestinal dilation and ascites; 1 case with clockwise rotation at 270°, neonatal US found SMV rotating clockwise around the SMA; 1 case of intestinal malrotation accompanied by intestinal torsion and necrosis was found on prenatal US. The tract was significantly dilated, and a mass next to it appeared as a “whirlpool sign”, accompanied by ascites. US has a unique value in diagnosing congenital intestinal malrotation and volvulus. The features include: specific direct signs such as intestinal “whirlpool sign”, abnormal position of superior mesenteric arteries and veins; non-specific indirect signs such as intestinal dilation, ascites, intra-abdominal calcification. Identifying the “whirlpool sign” and finding the location of the superior mesenteric arteries and veins are highly suggestive for intestinal malrotation and volvulus, while other indirect imaging findings are also important in assisting diagnosing.