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A 7 year old girl presents with acute abdominal pain and bilous vomitting
Midgut Volvulus

  • Torsion of gut around SMA from malrotation
  • Twist of 3.5 turns causes necrosis
  • 20% associated with other anomalies of GI tract: Duo atresia/diaphragm/stenosis, annular pancreas

This series of radiographs shows a large distended loop in the RUQ. There are other less dilated loops in the RLQ. The remainder of the abdomen is relatively gasless. The lateral decubitus view shows only a few small air fluid levels and the same distended loops
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A “corkscrew” pattern – proximal jejunum spiraling downward in right or mid upper abdomen in midgut volvulus
The “whirlpool sign” on color Doppler shows mesentery and flow within the SMV wrapping around the SMA (in a clockwise direction), indicating malrotation with volvulus


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These signals are relayed buying clomid online safe which then is by a number of such as medial preoptic and paraventricular nulcei.