Double bubble sign

Due to the exams tomorrow, i bet more than half will diagnose duodenal atresia when he/ she sees the double bubble sign, when in fact, there are numerous cause that can produce the same effect.Its not an exclusive sign, you know?

In general, this sign denotes an obstruction present, whether the cause is external or internal at the duodenum….probably the 2nd or 3rd part.

Causes:
Duodenal atresia/web/stenosis
Annular pancreas
Malrotation with volvulus
Preduodenal portal vein

It is accompanied by relative paucity of the lower GI tract.

An excerpt from here

The double-bubble is often accompanied by a relative paucity of lower GI gas. This is highly suggestive of volvulus or duodenal stenosis and atresia. A double-bubble sign with paucity of lower GI gas combined with clinical signs and symptoms of distress, such as fever, lower abdominal distention, melena, or hemodynamic instability, suggests volvulus and possibly gangrene and should lead directly to laparotomy. In this situation, pneumatosis coli may be observed on plain radiographs and is an ominous sign.

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Train your pretty eyes bayybeh!!!

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