Katz M E, Siegel M J, Shackelford G D, McAlister W H
AJR Am J Roentgenol. 1987 May;148(5):947-51. doi: 10.2214/ajr.148.5.947.
Forty-three control patients (neonate to 17 years old) were studied by upper gastrointestinal series to determine the position of key duodenal landmarks and the mobility of the duodenojejunal flexure with manual displacement. These results were compared with the duodenal positions of 35 children of similar ages with surgically documented malrotation. Nine criteria were identified as a useful means of detecting subtle abnormalities of duodenal position. The normal duodenojejunal flexure was found to be readily displaceable in neonates and could be pushed to the right of the spine in over two-thirds of patients less than 4 months old. Over 4 years of age, mobility was very limited. A mobile duodenum discovered on fluoroscopic examination or by positioning of a transpyloric feeding tube should not be considered indicative of malrotation in infancy.
对43名对照患者（新生儿至17岁）进行上消化道造影检查，以确定十二指肠关键标志的位置以及十二指肠空肠曲在手法移位时的活动度。将这些结果与35名年龄相仿、经手术证实有旋转不良的儿童的十二指肠位置进行比较。确定了九条标准，作为检测十二指肠位置细微异常的有用方法。发现正常的十二指肠空肠曲在新生儿中很容易移位，在三分之二以上4个月以下的患者中可被推至脊柱右侧。4岁以上，活动度非常有限。在透视检查中发现的可移动十二指肠或通过经幽门喂养管的定位发现的可移动十二指肠，不应被视为婴儿期旋转不良的指征。
