|A.||Congenital hypertrophic pyloric stenosis, Turner’s syndrome|
Duodenal atresia, Downs syndrome
Midgut volvulus, Klinefelter syndrome
Jejunal atresia, Patau syndrome
Ans. B. Duodenal atresia, Downs syndrome
The radiograph shows two gas shadows here, one being the gastric gas shadow and the other one just distal to pylorus, indicating duodenal gas shadow. This is referred to as a double bubble sign, a telltale indication of duodenal obstruction syndromes like duodenal atresia, duodenal stenosis, annular pancreas, etc. Here, in this clinical vignette of a neonate presenting with bilious vomiting would most likely be duodenal atresia, which happens to be more common in patients with Down’s syndrome.
Infantile hypertrophic pyloric stenosis ( previously called congenital ) presents typically with nonbilious vomiting in 3-5 weeks of life. And an abdominal radiograph can show only non-distended stomach gas.