Duodenal atresia

Question on Duodenal atresia was asked in AIIMS 2017 in April

Q) An infant presents with duodenal atresia. Which of the following is true about this condition?

a) It is the most common GI atresia

b) It presents soon after birth with non bilious vomiting

c) Pre natal detection of duodenal atresia is common

d) Gastro jejunostomy is the procedure of choice to bypass the obstruction

Answer (free) 

C- Commonly detected in the pre natal ultrasound

Duodenal atresia is seen in 1:5000 live births and most common atresia is jejunoileal (1in 2000). It is associated with lot of other congenital malformations like Down's,  prematurity, biliary atresia etc.

Duodenal atresia can have many stages like duodenal webs, complete stenosis and complete separation.

Mostly (80%) stenosis is distal to the ampulla of vater so the bile coming out from the ampulla goes in the stomach and infant presents with bilious emesis.

Typical radiographic sign is double bubble. One bubble in stomach and one in duodenum. Ante natal sonography is able to pick up most cases.

Duodenal atresia Double bubble sign
Double Bubble

 

Surgical options include- Duodenoduodenostomy and Duodenojejunostomy.

Another related MCQ to this question is that Double bubble sign is seen in which other conditions

  1. Duodenal stenosis
  2. Annular Pancreas
  3. Atresia of duodenum