Criteria of midgut malrotation (volvulus, malrotation) detected on fluoroscopy in children (Katz)

Katz et al. described nine findings for distinguishing normal and abnormal duodenal / jejunal positioning on upper gastrointestinal studies to detect subtle abnormalities indicative of midgut malrotation.

Malrotation of the gut

During development, the bowel rotates 270° anticlockwise in two locations: the foregut and midgut junction (duodenum) and midgut-hindgut location (cecum), so that the ligament of Treitz is located left to the midline and cecum reaches the right iliac fossa. Completeness of rotation can be classified into four cathegories:

Cathegory Description
Normal rotation Normal appearance of the gut, cecum in the right iliac fossa and the ligament of Treitz left to the midline

Hydronephrosis in Infants - SFU grading - Society of Fetal Urology

Hydronephrosis in infants is divided into five grades that were standardized by the Society of Fetal Urology. The grading is usually based on ultrasound, ev. intravenous urography.

Grade Description
Grade 0 no splitting of renal sinus
Grade I urine visible in renal pelvis only
Grade II urine fills intrarenal pelvis, extrarenal pelvis, major calyces are dilated

Gastroesophageal reflux - grading on barium study

In 1977, a grading system of gastroesophageal reflux on barium study was devised. It is based on the extent of retrograde flow of barium.

Grade Description
I reflux into distal esophagus only
II reflux extending above carina
III reflux into cervical esophagus
IV free persistent reflux into cervical esopagus with a wide open cardia (chalasia)
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