II. History
- Prenatal polyhydramnios in Duodenal Atresia
- Distal Intestine blocked from amniotic fluid absorption
III. Signs
- Duodenal Atresia
- Bilious Emesis
- Absent Abdominal Distention
- Typically presents early, while in newborn nursery
- Distal Small Bowel atresia (jejunum, ileum)
- Symptom onset delayed 12 to 24 hours after first feeding
- Bilious Emesis
- Abdominal Distention
- No meconium passage in first 24 hours in 80% of children
IV. Differential Diagnosis
-
Bilious Emesis and/or delayed meconium passage
- Hirschprung Disease
- Meconium Ileus (Cystic Fibrosis)
- Malrotation with Volvulus
V. Imaging
- Abdominal XRay
- Double Bubble Sign in Duodenal Atresia (large Stomach air filled bubble, smaller duodenal air filled bubble)
- Double-Bubble is also seen in Midgut Volvulus
- Water soluble enemas
- Differentiates atresia from meconium ileus and Hirschprung Disease
- Colon contracted in Intestinal Atresia (obstruction prior to ileocecal valve)
-
Abdominal Ultrasound
- Differentiates atresia from meconium ileus and Intestinal Malrotation
VI. References
- Jones (2022) Crit Dec Emerg Med 36(2): 14-5