What condition is indicated by a “corkscrew” appearance on a barium swallow study?

• A. Duodenal atresia
• B. Midgut volvulus
• C. Congenital diaphragmatic hernia
• D. Hirschsprung disease

Answer: (B)

The "corkscrew" appearance observed on a barium swallow study is most commonly associated with midgut volvulus. This condition arises when there is an abnormal twisting of the intestines, which can lead to obstruction and compromised blood supply to the affected segments. During a barium swallow study, the twisting can create a characteristic corkscrew shape in the contrast-filled bowel loops, allowing radiologists to identify the abnormality.

In the context of this question, midgut volvulus generally occurs in the setting of malrotation, which is a developmental abnormality during fetal life. This condition is most prevalent in infants, and the classic presentation includes bilious vomiting, abdominal distension, and sometimes bloody stools.

Other conditions presented in the options do not produce this specific imaging finding. For example, duodenal atresia typically presents with a "double bubble" sign on imaging, and congenital diaphragmatic hernia can be identified by the displacement of bowel into the thoracic cavity. Hirschsprung disease is more associated with constipation and distension due to the absence of ganglion cells in the distal colon, and it does not lead to a corkscrew pattern in imaging studies. Thus, understanding these characteristics helps clarify why the corkscrew appearance