Correlapaedia - a Correlative Encyclopedia of Pediatric Imaging, Surgery, and Pathology
This male was noted at 16 weeks on prenatal US to have polyhydramnios and a double bubble sign. A follow-up ultrasound at 24 weeks confirmed this finding. At birth at full term the patient had a massively distended abdomen and a nasogastric tube could not be passed to decompress the stomach.
Clinical Physical Exam:
The patient had a massively distended abdomen.
Clinical Differential Diagnosis:
Duodenal atresia and esophageal atresia
Abdominal films obtained soon after birth showed a gasless distended abdomen. An abdominal ultrasound from the first day of life showed a double bubble sign of a distended stomach and a distended duodenum.
Images 2 and 3
Imaging Differential Diagnosis:
Duodenal atresia and esophageal atresia.
The patient was surgically explored on the second day of life. Duodenal atresia was encountered. The patient had a duodeno-duodenostomy and G-tube placement performed.
Esophageal Atresia and Duodenal Atresia
Follow-up and Prognosis:
The patient had an uncomplicated post-operative course after the duodeno-duodenostomy and G-tube placement.
Contrast studies of the esophagus determined that it was impossible to perform a primary esophageal repair.
The patient therefore underwent a cervical esophagostomy. Later, the patient had a definitive esophageal colonic interposition.
Follow us on Twitter @pedseducation and @pedsimaging and Facebook @pedsimaging and Instagram @pedsimaging
Please send us comments by filling out our Comment Form.
All contents copyright © 1992-2016 Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D. and the authors. All rights reserved.
"Virtual Pediatric Hospital", the Virtual Pediatric Hospital logo, and "A digital library of pediatric information" are all Trademarks of Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D.
Virtual Pediatric Hospital is funded in whole by Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D. Advertising is not accepted.
Your personal information remains confidential and is not sold, leased, or given to any third party be they reliable or not.
The information contained in Virtual Pediatric Hospital is not a substitute for the medical care and advice of your physician. There may be variations in treatment that your physician may recommend based on individual facts and circumstances.