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Counterclockwise barber‐pole sign on prenatal three‐dimensional power Doppler sonography in a case of duodenal obstruction without intestinal malrotation
Author(s) -
Hsu ChinYuan,
Chiba Yoshihide,
Fukui On,
Sasaki Yoshihito,
Miyashita Susumu
Publication year - 2004
Publication title -
journal of clinical ultrasound
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.272
H-Index - 61
eISSN - 1097-0096
pISSN - 0091-2751
DOI - 10.1002/jcu.10225
Subject(s) - medicine , duodenal atresia , annular pancreas , clockwise , duodenum , power doppler , intestinal malrotation , radiology , volvulus , superior mesenteric vein , anatomy , superior mesenteric artery , atresia , surgery , ultrasonography , portal vein , amplitude , physics , quantum mechanics
Three‐dimensional (3D) power Doppler sonographic imaging provides a 3D view of the blood vessels. This technique reportedly has advantages over other forms of sonography in visualizing normal and abnormal fetal vascular anatomy. We report the case of a 36‐year‐old pregnant woman in whom 3D power Doppler sonography with simultaneous gray‐scale imaging was performed at 32 weeks' gestational age to investigate an intestinal obstruction in the fetus that was suspected on the basis of 2‐dimensional sonographic findings. The 3D sonograms revealed that the superior mesenteric artery and vein of the fetus were wound counterclockwise, forming the “barber‐pole” sign. At 38 weeks' menstrual age, the female infant was delivered vaginally. Only duodenal atresia and annular pancreas, but not intestinal malrotation, were found postnatally. Surgical reconstruction of the duodenum was performed, with no major complications. Previous research suggests that the counterclockwise barber‐pole sign is a normal finding. On the basis of our case, we believe that this “negative finding” might be used to exclude the diagnosis of midgut volvulus, a condition that would be expected to cause these vessels to wrap around in a clockwise direction. © 2004 Wiley Periodicals, Inc. J Clin Ultrasound 32:86–90, 2004