Abstract
The radiographic pattern ofhigh intestinal obstruction — gastric and duodenal distension with absence of small bowel gas (ASBG) or a completely gasless abdomen — may be present in infants with midgut volvulus. In most instances, ASBG is associated with viable small bowel. However, when associated with abdominal distension and tenderness ASBG usually reflectsstrangulated midgut volvulus and bowel necrosis.
In some patients with midgut volvulus there is a radiographic pattern oflow small bowel obstruction this is generally associated withnecrotic bowel.
These seemingly opposite observations can be explained by reviewing the dynamics of gas absorption in normal bowel and in closed loop intestinal obstruction. Impaired blood supply can result in either gaslessness or gaseous distension under differing conditions.
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George Kassner, E., Kottmeier, P.K. Absence and retention of small bowel gas in infants with midgut volvulus: Mechanisms and significance. Pediatr Radiol 4, 28–30 (1975). https://doi.org/10.1007/BF00978816
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DOI: https://doi.org/10.1007/BF00978816