Correlapaedia - a Correlative Encyclopedia of Pediatric Imaging, Surgery, and Pathology
The patient was a full term female, 1 day old, noted to have copious secretions in the delivery room where 50 cc of bile stained gastric secretions were aspirated. Upon further questioning it was learned that a prenatal US at 20 weeks had revealed fetal bowel distension with no evidence of polyhydramnios.
Clinical Physical Exam:
The abdomen was soft, without palpable masses.
Clinical Differential Diagnosis:
An abdominal film from the first day of life showed a double bubble sign.
Imaging Differential Diagnosis:
Duodenal atresia, duodenal stenosis.
The patient was explored on the first day of life via a right supraumbilical transverse incision. The duodenum was seen to taper between the second and third portions. A nasogastric tube could not be advanced past this area of tapering. There appeared to be a membrane obstructing the duodenum at this point. A duodenotomy was performed which confirmed the presence of a thick membrane completely obstructing the duodenum. Bile was seen above and below this membrane. The bile was coming from one papilla above the membrane and one below it. The dividing membrane was then incised.
Duodenal Atresia with air passing distally through pancreatic ducts
Follow-up and Prognosis:
The patient had an uncomplicated post-operative course.
Case 4, Case 6, Case 14, Case 18, Case 23
Follow us on Twitter @pedseducation and @pedsimaging
Please send us comments by filling out our Comment Form.
All contents copyright © 1992-2015 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.