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Frontal view of the abdomen with double bubble sign, patient was found to have duodenal atresia. In radiology, the double bubble sign is a feature of pediatric imaging seen on radiographs or prenatal ultrasound in which two air filled bubbles are seen in the abdomen, representing two discontiguous loops of bowel in a proximal, or 'high,' small bowel obstruction.
The diagnosis of duodenal atresia is usually confirmed by radiography. An X-ray of the abdomen is the first step in evaluation. The x-ray should be obtained after placement of a nasogastric tube (feeding tube), evacuating the stomach and filling 40-50 ml of air [5] to demonstrate two large air filled spaces, the so-called "double bubble" sign.
The most common cause of non-duodenal intestinal atresia is a vascular accident in utero that leads to decreased intestinal perfusion and ischemia of the respective segment of bowel. [3] This leads to narrowing, or in the most severe cases, complete obliteration of the intestinal lumen .
Pneumoperitoneum is pneumatosis (abnormal presence of air or other gas) in the peritoneal cavity, a potential space within the abdominal cavity.The most common cause is a perforated abdominal organ, generally from a perforated peptic ulcer, although any part of the bowel may perforate from a benign ulcer, tumor or abdominal trauma.
High obstruction can be suspected based on the double bubble sign. Cases without distal gas are usually related to duodenal atresia, while high obstruction with distal gas need an upper gastrointestinal series because of the need to distinguish duodenal web , duodenal stenosis and annular pancreas from midgut volvulus , the latter being a ...
Abdominal radiography can show the classic sign of the "double bubble": the presence of air in the stomach and duodenum. [5] [6] Unfortunately, this double-bubble sign is not pathognomonic for annular pancreas, as it can also be observed in other conditions, such as duodenal atresia [7] and intestinal malrotation. [8]
X-ray from the underside of a dog with GDV. The dark area is the buildup of gas. Gastric dilatation volvulus ( GDV ), also known as gastric dilation , twisted stomach , or gastric torsion , is a medical condition that affects dogs and rarely cats and guinea pigs , [ 1 ] in which the stomach becomes overstretched and rotated by excessive gas ...
Although the baby is exposed to radiation, an upper GI series (X-rays taken after the baby drinks a special contrast agent) can be diagnostic by showing the pylorus with elongated, narrow lumen and a dent in the duodenal bulb. [7] This phenomenon caused "string sign" or the "railroad track/double track sign" on X-rays after contrast is given ...