Infant with Down's syndrome

Sunday, December 27, 2009
This is an X-ray of an infant with Down's syndrome.His mother has been found to have polyhydramnios by USS during the Antenatal period.Comment on this X-Ray?



ANSWER - Duodenal atresia

Duodenal atresia may be due to a complete absence of the duodenum.

The duodenum is filled with epithelial cells at about five weeks gestation. It then undergoes vacuolization and recanalisation by week eight.
Failure of this process results in atresia.

CLINICAL FEATURES
There is an association with Down's syndrome.
Bile contain Vomitus
Distened Stomach

Differential Dx - Oesophageal Atresia, Pyloric Stenosis, Congenital Proximal Intestinal Obstruction

INVESTIGATIONS
Plain abdominal X-ray: this may show a 'double bubble' sign of duodenal obstruction
Barium study may show stenosis
Electrolyte and acid-base status measures

TREATMENT
Surgical Intervention- Duodenojejunostomy with resection of the atretic section




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4 comments

  1. Anonymous Says:
  2. oesophgeal atresia

     
  3. Jacknaim Says:
  4. double bubble sign associated with duodenal atresia suggested by down syndrome+polyhydramnios.
    check out my profile

    http://jacknaimsnotes.blogspot.com/2009/12/duodenal-atresia-in-pre-term-infant.html

     
  5. xydau Says:
  6. In oesophageal Atresia you can detect polyhydroamniosis during the antenatal period.But In this Xray you will see the double bubble appearence which is a characteristic feature of Duedenal atresia which may be seen in 8% of patient with Down's Syndrome.

     
  7. Bobbymurjani Says:
  8. Double bubble --> atresia duodenum

     

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