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Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed
The ratio of duodenal atresia to duodenal stenosis is 4:1. The point of atresia is distal to the ampulla of Vater in 75-80% of patients. Related anomalies include: Downs Syndrome in 30%, esophageal atreasia and tracheoesophageal fistula in 13%, multiple intestinal atresias in 15%, and annular pancreas in 21%.
On an abdominal film, a gas distended stomach and duodenum gives the "double bubble" sign with no gas distal to the duodenum in duodenal atresia. Once duodenal obstruction is recognized further imaging is usually unnecessary as surgery is indicated emergently. If further imaging is required, air, non-ionic contrast or barium can be injected though a nasogastric tube to better outline the level of obstruction.
High bowel obstruction
See References Chapter.
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