tatappt final
TRANSCRIPT
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AN INTERESTING CASE OF
PEDIATRIC EPIGASTRIC
LUMP
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History and clinical features
• A 10 yr old girl came with
complaints of
– Acute pain in epigastric region and
bilious vomiting since 2-4 days.
– O/E : Epigastric lump with localised
tenderness was noted.
– Temperature was slightly raised.
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Erect plain X Ray AP View
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Doppler on ultrasound
SMV
SMA
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Upper GI study
Pylorus and
duodenal bulb
noted to the right
Direction of
barium flow
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A NORMAL BARIUM STUDY
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OUR PATIENT
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NORMAL BARIUM STUDY LATERAL VIEW
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OUR PATIENT BARIUM
STUDY LATERAL VIEW
“CORKSCREW
APPEARENCE”
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Malrotation of Gut with
Midgut volvulus
Final diagnosis
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Pedicle of the
volvulus
Superior mesenteric
artery noted along the
pedicle
Mesenteric
attachment
Segment of
intestine
alongwith the
volvulus
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TAKE HOME MESSAGE
Upper
gastrointestinal
barium studies
are NOT obsolete
Dynamic USG for
demonstrating
the WHIRLPOOL
SIGN
Accurate
knowledge of
normal
appearances of
upper GI series
FINAL DIAGNOSIS