The intra-uterine demonstration of duodenal atresia by ultrasound

Abstract

Duodenal atresia is rapidly fatal unless diagnosed promptly and treated surgically without delay. The radiological features are usually diagnostic. A plain erect abdominal X ray of the new-born infant shows two large fluid levels, one in the stomach, the other in the distended duodenum proximal to the atretic segment. No intestinal gas shadows are seen distal to the obstruction. This gives the classical “double bubble” appearance. Duodenal atresia is one of the rarer causes of hydramnios. If it could be diagnosed antenatally by ultrasound and the diagnosis confirmed by conventional radiography immediately after birth, it would be possible to relieve the obstruction surgically before electrolyte disturbances adversely affect the prognosis. The following case report describes the ultrasound B-scan appearances of duodenal atresia in utero.