Duodenal atresia: not always a double bubble

Latzman, Jonathan M.; Levin, Terry L.; Nafday, Suhas

doi:10.1007/s00247-014-2896-1

Cited by 21 publications

(13 citation statements)

References 8 publications

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“…This finding is best visualized in cases of duodenal atresia or severe stenosis in which the proximal, left-sided bubble represents air and fluid in the stomach and the distal, right-sided bubble represents air in the dilated segment of the proximal duodenum [12]. Variations of this radiographic finding may be seen including the presence of distal bowel gas depending on the degree and location of obstruction [13]. Ultrasound can also be used in the antenatal period to raise suspicion of duodenal obstruction by demonstrating fluid filled structures in the upper abdomen with a paucity of fluid distally [12].…”

Section: Discussionmentioning

confidence: 99%

Simultaneous duodenal stenosis and duodenal web in a newborn

Erickson

Retrouvey

Rush

et al. 2016

Radiology Case Reports

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Failure of duodenal recanalization results in a spectrum of proximal bowel obstruction from stenosis to atresia. Associations between congenital duodenal obstruction and other congenital anomalies have been well documented although the coincidence of duodenal stenosis and duodenal web is incredibly rare, posing a unique diagnostic challenge. We report a case of a full-term 4-day-old female child presented with forceful, bilious emesis and poor oral intake with decreased frequency of urination, and stooling whose initial abdominal radiograph showed several loops of gas-filled bowel in the distal stomach and proximal duodenum mimicking the classic “double-bubble” sign. An upper gastrointestinal barium contrast study revealed distention of the duodenal bulb with an abrupt narrowing and subsequent dilation at the second portion of the duodenum raising the suggestion of multiple duodenal obstructions. Ladd’s procedure was performed, and the stenotic and webbed segments were bypassed with a Kimura diamond-shaped duodenoduodenostomy.

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Section: Discussionmentioning

confidence: 99%

Simultaneous duodenal stenosis and duodenal web in a newborn

Erickson

Retrouvey

Rush

et al. 2016

Radiology Case Reports

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“…Oesophageal and duodenal atresia make up a major part of congenital lower and upper gastrointestinal system emergencies with an incidence of 1 in 2500–3000[ 9 ] and 1 in 10,000,[ 10 ] respectively, and jejunoileal atresia in the lower gastrointestinal system is the most common emergency cases with an incidence of 1in 5000. [ 11 ] In our study group, most also had oesophageal and small intestinal atresias, which made up approximately one-third of cases.…”

Section: Discussionmentioning

confidence: 99%

Albumin Haemoglobin Index

Silahli

Tekin

2022

African Journal of Paediatric Surgery

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Aim: The aim of this study was to evaluate the mortality and morbidity of infants <1 year of age with intestinal obstruction requiring surgical intervention and to investigate the factors affecting mortality and hospital length of stay in paediatric surgery, including albumin-haemoglobin index. Patients and Methods: The records of gastrointestinal paediatric surgeries in the past 10 years of patients who were <1-year-old at Baskent University Konya Hospital were obtained from the hospital and retrospectively studied. Patient characteristics, especially the relationship between albumin haemoglobin index (AHI) and hospital duration and mortality, were examined. According to the surgical areas, it also subjected this relationship to further analysed in subgroups. Results: There were 144 cases who fulfilled the inclusion criteria. Pre-operative serum AHI was analysed using receiver operating characteristics (ROC) curve analyzes. In the ROC analysis, AHI had a diagnostic value in predicting case discharge rates (area under the curve: 0.755, P = 0.001). When the cut-off point was set at 46.18, the sensitivity of the test was 57.5% and the sensitivity for predicting survival was 84%. In the logistic regression model to estimate survival, the odds ratio of AHI was 1.063 (confidence interval: 1.020–1.108, P = 0.004). In subgroup analyzes, AHI positively predicted survival in the NEC group and in the other group. In a linear regression model analysing the effect of AHI on hospital stay of length, AHI explained 10% of the variance in the hospital stay of length variable and significantly and negatively influenced the hospital length variable (β = −0.319, P = 0.05). In the linear regression model for subgroup analyzes, AHI significantly and negatively predicted hospital length of stay in the NEC and pyloric surgery groups, but positively predicted hospital length of stay in the perforation group. Conclusion: The AHI can be used as a valuable marker to predict the likelihood of discharge and length of hospital stay in paediatric surgical cases <1-year-old.

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“…Unlike more distal small bowel (jejunal/ileal) atresia which is believed to be caused by an ischemic episode, DA is believed to result from the failure of the recanalization of the bowel lumen following the phase of epithelialization, proliferation, and subsequent vacuolization of the alimentary tract during embryonic development [ 6 – 8 ]. Between the 30th and 60th days of embryonic development, growth and differentiation of the alimentary tract are proceeding at great speed.…”

Section: Discussionmentioning

confidence: 99%

Biliary Tract Abnormalities as a Cause of Distal Bowel Gas in Neonatal Duodenal Atresia

Puvabanditsin

Botwinick

Chen

et al. 2018

Case Reports in Surgery

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Background The presence of distal bowel gas in an infant does not exclude the diagnosis of duodenal atresia. Case Presentation We report a term neonate with Down syndrome. The infant developed vomiting and cyanosis with each feeding soon after birth. Plain film abdominal X-rays showed a nonspecific gas-filled stomach and small bowel. Duodenal atresia and an anomalous common bile were noted on an upper GI study and exploratory laparotomy. Conclusion In the absence of a “double bubble” appearance and intestinal gas distally on a plain radiograph, one must not exclude duodenal atresia as the differential diagnosis.

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Duodenal atresia: not always a double bubble

Cited by 21 publications

References 8 publications

Simultaneous duodenal stenosis and duodenal web in a newborn

Simultaneous duodenal stenosis and duodenal web in a newborn

Albumin Haemoglobin Index

Biliary Tract Abnormalities as a Cause of Distal Bowel Gas in Neonatal Duodenal Atresia

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