Double bubble

Double Bubble
Other names	Duodenal atresia
Specialty	Pediatrics, Gastroenterology
Symptoms	Vomiting, abdominal distension
Usual onset	Typically at birth
Duration	Long-term
Causes	Congenital
Diagnostic method	Ultrasound, X-ray
Treatment	Surgery
Frequency	Rare

Double bubble is a medical term used to describe a characteristic radiological finding that indicates the presence of duodenal atresia, a congenital obstruction of the duodenum, which is the first part of the small intestine. This condition is typically diagnosed shortly after birth and is marked by a distinctive appearance on an X-ray, where two air-filled spaces, or "bubbles," are visible in the abdomen.

Causes

The exact cause of duodenal atresia is not well understood, but it is believed to be related to abnormal development of the duodenum during the embryonic stage of pregnancy. It is often associated with other congenital conditions such as Down syndrome.

Symptoms

Infants with duodenal atresia typically present symptoms shortly after birth, which may include vomiting (often green due to bile), lack of bowel movement, and abdominal swelling. The vomiting and other symptoms arise because the obstruction prevents food and stomach contents from passing through the digestive tract.

Diagnosis

Diagnosis of duodenal atresia and the double bubble sign is typically made through prenatal ultrasound or postnatal abdominal X-rays. The double bubble sign is a key indicator, showing two distinct air-filled spaces: one in the stomach and the other in the proximal duodenum.

Treatment

The primary treatment for duodenal atresia is surgical intervention to correct the obstruction. This typically involves a procedure known as duodenoduodenostomy, where the obstructed part of the duodenum is bypassed or removed. Early diagnosis and surgical treatment are crucial for a positive outcome.

Prognosis

With prompt surgical treatment, the prognosis for infants with duodenal atresia is generally good. However, long-term outcomes depend on the presence of associated anomalies and the overall health of the infant.

Epidemiology

Duodenal atresia is a rare condition, occurring in approximately 1 in 10,000 live births. It has a higher incidence in infants with Down syndrome.