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Fig. 1B —34-year-old man with nonspecific abdominal pain. Axial MRI
small-bowel follow-through reveals abnormal anterior relationship of third
part of duodenum relative to superior mesenteric vessels (white
arrows, A). Compression and torsion of duodenum as it courses
anteriorly results in beak sign (arrowhead, A). At same level,
superior mesenteric vein passes posterior to superior mesenteric artery,
creating "swirl sign" (black arrow, A). Further
distally, duodenum courses posteriorly around mesenteric vessels, providing
corkscrew appearance (white arrows, B and C). High
cecum (curved black arrows, A–C) and terminal ileum
(curved white arrow, B and C) are shown. These findings
are typical of malrotation.