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Question 2 Is Doppler ultrasound superior to upper gastrointestinal contrast study for the diagnosis of malrotation?
  1. Michael A Quail
  1. Correspondence to Michael Quail, Cardiac Unit, Great Ormond Street Hospital for Children, Great Ormond Street, London WC1N, UK; michael.quail{at}googlemail.com

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Scenario

Three-day-old twins are reported to have persistent bilious vomiting on the postnatal ward. You suspect midgut malrotation and it is suggested by a colleague that a Doppler ultrasound might be a better investigation than an upper gastrointestinal (UGI) contrast study, as it does not involve radiation and is non-invasive. You are uncertain which test is best.

Structured clinical question

In an infant with bilious vomiting [patient], is a Doppler ultrasound [intervention] superior to an UGI contrast study [comparison] for the diagnosis of malrotation [outcome]?

Search strategy

Secondary sources

A search of the Cochrane database of systematic reviews and BestBETS website identified no relevant articles.

Primary sources

An Ovid Medline (1950–2010) search was performed using the search terms: Intestinal Volvulus/or malrotation.mp. AND ultrasound.mp.

Search limits

Searches were limited to English language, human, infant (birth–23 months).

A total of 37 articles were retrieved, and the abstracts were reviewed. Four relevant studies were identified (see table 2).

View this table:
Table 2

Is Doppler ultrasound superior to upper gastrointestinal contrast study for the diagnosis of malrotation?

Commentary

Malrotation of the midgut is a congenital abnormality …

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Footnotes

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Competing interests None.