The caecum is found to be placed below the stomach and in the midline. Which of the following abnormality must have taken place while rotation of the gut:
Correct Answer: Mixed rotation
Description: D i.e. Mixed rotation The suspensory ligament of duodenum (ligament of Treitz) is usually found to the left of body of L1 or L2 (first or second lumber veebrae) after normal gut rotation (Gray 1209). A Key element for diagnosis of rotational abnormalities of intestine is the position of ligamentum Treitz, which should normally be located to the left of midline and at the level of gastric antrum. (Sabiston-2110). Any other position of this ligament may indicate some degree of malrotation. On barium studies duodenojejunal flexure should thus lie to the left of upper lumbar spine at the level of pylorus (Gay 1209)Left sided colon occurs if the midgut loop has not rotated at all; mixed rotation results in the cecum lying inferior to the pylorusQ. (Grays-1209)So nonrotation is characterized by left sided large intestine & right sided small intestineQ; reversed rotation by duodenum lying anterior and transverse colon posterior to SMAQ. And mixed rotation by cecum lying just inferior to the pylorus of stomachQ.If the cecum adheres to the inferior surface of liver when it returns to abdomen, it will be drawn superiorly as the liver diminishes in size resulting in subhepatic cecum & high riding appendix (its fetal position).
Category:
Anatomy
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