PMC3894915_01
Abdominal radiograph demonstrating air in the liver.
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An upright plain abdomen X-ray revealed some air in the biliary system with no additional intestinal obstruction findings (Figure 1).
Contrast-enhanced CT demonstrates gas in the biliary system. Coronal reconstruction of CT scan showing reliable findings with malrotation, with the colon predominantly located in the upper abdomen and left flank, and multiple gas filled loops of the small bowel located in the right lower quadrant. No intra-abdominal free air and portal venous gas was seen.
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Air was visualized within the gallbladder, common bile duct, and the intrahepatic biliary ductal system (Figure 2). In addition, the CT scan was unexpectedly suggestive of intestinal malrotation, with the colon located in the left abdomen, and the small bowel located in the right side (Figure 2).
The schematic view.
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An intestinal malrotation was consequently diagnosed; Figure 3 provides an illustrated schematic view.