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Clinical presentation:
Incidental finding in a young woman under investigation for dyspepsia.

In this barium study, the stomach and duodenal cap are underfilled. The bowel lies on the right side, but is otherwise normal. Instead of winding around the head of the pancreas to the normal site of the duodeno-jejunal flexure on the upper left margin of the second lumbar vertebra, the bowel lies in the right para-colic gutter. There is no extrinsic impression or obstruction.

In utero, there is a large hernia into the umbilicus. As the foetus grows so the bowel returns with rotation as it folds into the abdomen. The present condition results from incomplete rotation.

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[London South Bank U.]

IDM Oct 2006