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Virtual Pediatric Hospital: Paediapaedia: Upper GI for Malrotation Paediapaedia: Gastrointestinal Procedure Descriptions

Upper GI for Malrotation

Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed

Patient Preparation:

Barium or low osmolar nonionic - never use Gastrografin because if aspirated it can cause severe pulmonary edema.

Use nasogastric tube or 8 french feeding tube with the tip in stomach - fluoroscope to check this first.
Don't over distend stomach with contrast.
Start with left side down.
Give 5-10 cc of contrast through the nasogastric tube.
Turn to right side down to facilitate gastric emptying.
When contrast is seen to enter 3rd/4th part of duodenum, turn the patient supine and document the position of the duodenal jejunal junction with a spot film.
Aspirate the stomach at the end of the exam.

Views to Take:
Document the position of the Ligament of Treitz

See References Chapter.

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