Volvulus of the entire small bowel with normal bowel fixation simulating malrotation and midgut volvulus.

Background: Midgut volvulus is a complication of malrotation of bowel and mesenteric malfixation. In contrast, primary volvulus of the small bowel is a distinctly different and rare entity characterized by torsion of the entire small bowel with normal mesenteric fixation.

Objective: To present the clinical and imaging findings in four infants with primary small bowel volvulus and normal bowel fixation in order to improve awareness of this entity among clinicians and radiologists and to discuss the potential etiologies of this entity to distinguish it from other causes of small bowel volvulus.

Side-to-side and interpolar renal duplications: the nonpolar variety.

The Weigert-Meyer rule predicts the draining pattern of duplex ureters in bipolar renal duplications. This paper introduces two cases of nonpolar renal duplication. A 3-month-old and a 15-year-old female with history of urinary tract infection were evaluated with intravenous pyelograms (IVP) and eleven different parameters were analyzed.

Pericardial tamponade with a normal cardiopericardial silhouette due to a penetrating metallic projectile propelled by a lawnmower.

This report describes a case of pericardial tamponade in a 6-year-old boy due to a penetrating projectile coat hunger wire propelled by a lawnmower. A dismissible dermal injury at the entry point and a normal initial cardiopericardial silhouette are reported. The report issues a new warning to be added to the warnings already listed in lawnmower manuals.

Salt losing obstructive uropathy with paradoxically low urinary sodium concentration: salt entrapment in an obstructed ectopic ureterocele.

A 6-month-old hyponatremic female with failure to thrive had low urinary sodium concentration. Renal sonography revealed a duplex left collecting system with obstruction of the upper moiety as a blind-ended ectopic ureterocele extending to the bladder base. The echogenicity of the urine within the upper pole system was greater than the bladder contents.

Assessment of retromesenteric position of the third portion of the duodenum: an US feasibility study in 33 newborns.

Background: US can be used to assess bowel and does not require ionizing radiation or the administration of contrast material. Prior studies of the duodenum with US are limited.

Objective: This study assesses the success rate of US demonstration of the third portion of the duodenum (D3) between the superior mesenteric artery (SMA) and the aorta in newborns to exclude malrotation based on embryologic and anatomic principles.

Biphasic threat to femoral head perfusion in abduction: arterial hypoperfusion and venous congestion.

Background: Hip abduction can cause avascular necrosis (AVN) of the femoral head in infants.

Objective: To compare the US perfusion pattern of femoral head cartilage in neutral position with that in different degrees and duration of abduction, testing the venous congestion theory of post-abduction ischemia.

Materials And Methods: In 20 neonates, the Doppler flow characteristics of the posterosuperior (PS) branch of the femoral head cartilage feeding vessels were evaluated in neutral and at 30 degrees, 45 degrees, and 60 degrees abduction.

The position of the duodenojejunal junction: the wrong horse to bet on in diagnosing or excluding malrotation.

Purpose: The purpose of this communication is to highlight the shortcomings of all currently used imaging criteria in diagnosing or excluding malrotation and offer ultrasound demonstration of the 3(rd) portion of the duodenum (D3) between the AO and the SMA in transverse and sagittal plains as the most reliable diagnostic method.

Background: Although UGI is currently considered to be the imaging modality of choice in diagnosis of malrotations, numerous publications indicate that in certain patients, false positives and negatives can be encountered.

Materials And Methods: The material consists of more than 10 years experience in university settings, during which the author has used US as the definitive imaging modality for the work-up of malrotation.

Internal barium shielding to minimize fetal irradiation in spiral chest CT: a phantom simulation experiment.

Purpose: To use a phantom to prospectively examine the attenuating effect of barium sulfate as an internal shield to protect the fetus.

Materials And Methods: In an adult-size phantom, 1- and 2-cm-thick acrylic slabs containing 315 or 630 mL of water, 2% or 40% barium sulfate suspension, and a 1-mm lead sheet were placed under the diaphragm. In 17 experiments, fetal dose was measured by using thermoluminescent dosimeters that were placed immediately under (near field) and 10 cm below (far field) the water slab (eight experiments), barium sulfate slab (eight experiments), and lead sheet (one experiment).