Podury Ruchika,  Dagar Saloni,  Weiss Danielle,  Amodio John,  Blumfield Einat,  Levin Terry

Final Pr. ID: Poster #: EDU-035

Intraluminal post bulbar duodenal masses in children may be solid or cystic, congenital, neoplastic or post traumatic. The aim of this educational exhibit is to present the imaging findings of these duodenal masses using fluoroscopy, ultrasonography, computed tomography and magnetic resonance imaging and discuss the role of imaging. In addition, the clinical implications of these entities will be discussed. The cases will include: duodenal duplication cyst, duodenal web, choledochocele, duodenal hematoma, and duodenal adenoma. Read More

Authors:  Podury Ruchika , Dagar Saloni , Weiss Danielle , Amodio John , Blumfield Einat , Levin Terry

Keywords:  Duodenum, Abdominal Imaging, Pediatric Imaging

Mcgehee Arianna,  Wu Yen-ying,  Singh Jaspreet,  Mckinney Caleb,  Manalo Carlo

Final Pr. ID: Poster #: SCI-015

Midgut malrotation can lead to significant morbidity and even mortality if complicated by volvulus or obstruction related to Ladd bands. At our institution, it is routine practice to perform fluoroscopic upper gastrointestinal (UGI) exams to assess for intestinal malrotation prior to gastrostomy tube placement. We sought to determine if it is feasible to assess midgut rotation using any previous MRI exams that include the upper abdomen. We hope to remove the need for upper GI exams in patients with previous MRI exams, thus preventing unnecessary radiation exposure and overutilization of resources, prior to gastrostomy tube placement. Read More

Authors:  Mcgehee Arianna , Wu Yen-ying , Singh Jaspreet , Mckinney Caleb , Manalo Carlo

Keywords:  UGI, third portion of duodenum, SMA-aorta axis

Zawin Joan,  Buyukkaya Ayla

Final Pr. ID: Poster #: CR-016

Case Report
Duodenum inversum is an uncommon congenital anomaly, in which the duodenum ascends to the level of the duodenal bulb, then passes posteriorly before crossing the midline above the pancreas.
This condition is thought to result from the persistence of the dorsal mesentery, leading to increased mobility of the duodenum. It is frequently associated with fixation or positional anomalies of the right kidney, pancreas, and transverse mesocolon.
Diagnosis is typically made via upper gastrointestinal (GI) series or laparoscopy, but may be delayed or overlooked if the configuration of the proximal duodenum is not carefully evaluated.
Although often asymptomatic, when symptoms such as vomiting, abdominal pain, or signs of obstruction are present, accurate diagnosis through imaging is essential for appropriate management. Awareness of this condition can help differentiate it from disorders such as malrotation, duodenal obstruction, or superior mesenteric artery (SMA) syndrome, and prevent potential complications associated with misinterpretation of imaging findings.
Associated conditions can include pancreatitis, gallbladder disease, duodenal ulcer, and, more rarely, gastric ulcer. Many of these symptoms are believed to result from stasis within the duodenal loop.
We present the case of a 1-year-old child with a history of hypoxic ischemic encephalopathy, who underwent upper GI imaging for evaluation of vomiting that had worsened over the past two weeks. On imaging, the first and second portions of the duodenum appeared normal. However, the third portion of the duodenum did not cross the midline, as would be expected. Instead, it ascended on the right side of the spine, posterior and parallel to the descending duodenum, reaching the level of the duodenal bulb. It then completed a transverse course to the left upper abdomen, where the duodenojejunal junction was appropriately located on the left side of the spine, at the level of the duodenal bulb findings consistent with duodenum inversum.
Treatment is primarily medical in the absence of obstruction. In cases where obstruction is attributed to SMA syndrome, transpyloric feeding is considered. Surgical intervention is reserved for cases of obstruction caused by fibrotic bands, in which a partial Ladd’s procedure may be performed. Read More

Authors:  Zawin Joan , Buyukkaya Ayla

Keywords:  Abdominal Imaging, Duodenum, Upper GI Study

Venkatakrishna Shyam Sunder,  Elsingergy Mohamed,  Calle Toro Juan,  Dennis Rebecca,  Andronikou Savvas

Final Pr. ID: Poster #: SCI-004

Upper gastrointestinal studies are used for the diagnosis of intestinal malrotation, and the configuration of the duodenum and position of the DJ flexure are used for diagnosis. There are various challenges associated with diagnosing malrotation on the AP view, and obtaining a lateral view is recommended for diagnosis. To be useful, the lateral view must be of adequate quality. In addition, radiologists must be aware of the normal appearance and configuration of duodenal variants such as duodenum redundum, on the lateral view, as misdiagnosis of these may lead to unnecessary surgery. We aim to determine the proportion of lateral views considered of adequate quality for diagnosis, as well as the prevalence of a not previously described sign, the 'descending stair' and its correspondence to a diagnosis of duodenum redundum. Read More

Authors:  Venkatakrishna Shyam Sunder , Elsingergy Mohamed , Calle Toro Juan , Dennis Rebecca , Andronikou Savvas

Keywords:  Descending stair, Upper gastrointestinal studies (UGI), Duodenum redundum