RADIOLOGY: ABDOMEN: Case# 33643: MALROTATION WITH VOLVULUS. Newborn with bilious emesis. KUB (not included) showed multiple loops of dilated bowel. An upper GI series was performed which revealed a normal appearing stomach. Contrast passed readily into the duodenum which had a cork screw or spiral appearance. The duodenal-jejunal junction was not in normal position, indicating malrotation. The small bowel filled to the right of the spine. The study was stopped at this point and the patient was sent emergently to the operating room for surgery. Laparotomy revealed malrotation with volvulus. The ischemic bowel was resected. A Ladd procedure was performed to appropriately reposition the small bowel mesentery. The diagnosis of malrotation can be suggested on ultrasound when the superior mesenteric vein is found to lie to the left of or anterior to the superior mesenteric artery. False positives and negatives have been reported and a contrast exam remains the gold standard examination.