A postnatal X-ray of abdomen of a neonate shows 'double bubble sign'. It is seen with:: (A) Pyloric stenosis, (B) Duodenal atresia, (C) Ileal atresia, (D) Esophageal atresia
Answer is B. In duodenal atresia, postnatal abdominal plain radiographs show gaseous distention of the stomach and proximal duodenum (the "double-bubble" radiologic sign). With protracted vomiting, there is less air in the stomach and less abdominal distention. Absence of distal intestinal gas suggests atresia or severe extrinsic obstruction, whereas a pattern of intestinal air scattered over the lower abdomen may indicate paial duodenal obstruction. Ref: Sundaram S.S., Hoffenberg E.J., Kramer R.E., Sondheimer J.M., Furuta G.T. (2012). Chapter 21. Gastrointestinal Tract. In W.W. Hay, Jr., M.J. Levin, R.R. Deterding, J.J. Ross, J.M. Sondheimer (Eds), CURRENT Diagnosis & Treatment: Pediatrics, 21e.