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Malrotation — RACP Paediatrics MCQ

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ModerateGIMalrotationRACP Paediatrics

A neonate presents on day 2 of life with bilious vomiting. The abdomen is not distended and the baby is haemodynamically stable. What is the most appropriate urgent investigation?

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Correct answer: D — Upper GI contrast study

An upper GI contrast study is the investigation of choice to assess for malrotation in a neonate with bilious vomiting. It identifies the position of the duodenojejunal flexure (ligament of Treitz). An abnormal position (to the right of or below the expected location) confirms malrotation.

Reference: RCH Melbourne – 2023 – Bilious Vomiting CPG; RACP Paediatric Curriculum – Gastroenterology