Malrotation and Volvulus

[size=6]You are called by the emergency department to consult on a ten-day old full term male infant with bilious vomiting. The baby is hemodynamically stable and the abdominal exam is unremarkable. An abdominal ultrasound obtained by the emergency physician suggests that the superior mesenteric artery lies to the right of the vein and that there might be “swirl sign”. Your plan in this patient with bilious vomiting should be immediate A repeat the ultrasound with graded compression B upper gastrointestinal series. C contrast enema. D computerized tomography of the abdomen. E laparotomy.[/size]

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First one with correct answer with justification win. [size=20px]You are called by the emergency department to consult on a ten-day old full term male infant with bilious vomiting. The baby is hemodynamically stable and the abdominal exam is unremarkable. An abdominal ultrasound obtained by the emergency physician suggests that the superior mesenteric artery lies to the right of the vein and that there might be “swirl sign”. Your plan in this patient with bilious vomiting should be immediate A repeat the ultrasound with graded compression B upper gastrointestinal series. C contrast enema. D computerized tomography of the abdomen. E laparotomy.[/size]

Any one want a high quality PDF of this chart, post in this thread and use a personalized picture as an avatar, I will send it to you in a private message edit available without restrictions, see below

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Saudi pediatric Surgery board lectures, download from next post