Double bubble sign

Radiological sign indicating duodenal atresia

Double bubble sign
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Synonyms	N/A
Pronounce	N/A
Specialty	N/A
Symptoms
Complications
Onset
Duration
Types	N/A
Causes	Duodenal atresia, Annular pancreas, Duodenal stenosis
Risks	N/A
Diagnosis	X-ray, Ultrasound
Differential diagnosis	N/A
Prevention	N/A
Treatment	Surgical intervention
Medication	N/A
Prognosis	N/A
Frequency	N/A
Deaths	N/A

The double bubble sign is a radiological finding typically observed on prenatal ultrasound or postnatal X-ray imaging. It is characterized by the appearance of two distinct, round areas of radiolucency in the upper abdomen, which represent a distended stomach and duodenum. This sign is most commonly associated with duodenal atresia, a congenital condition where the duodenum is closed or absent, preventing the passage of stomach contents into the intestines.

Etiology

The double bubble sign is primarily indicative of duodenal atresia, but it can also be seen in other conditions such as:

• Annular pancreas: A condition where the pancreas forms a ring around the duodenum, potentially causing obstruction.
• Duodenal stenosis: A narrowing of the duodenum that can lead to partial obstruction.
• Malrotation with midgut volvulus: A condition where the intestines are not in their normal position, which can lead to twisting and obstruction.

Pathophysiology

In duodenal atresia, the failure of recanalization of the duodenum during embryonic development results in a blockage. This leads to the accumulation of swallowed amniotic fluid in the stomach and proximal duodenum, creating the characteristic "double bubble" appearance on imaging.

Diagnosis

The double bubble sign can be detected through:

• Prenatal ultrasound: Often identified during routine prenatal screening, the double bubble sign can suggest duodenal atresia or other gastrointestinal obstructions.
• Postnatal X-ray: After birth, an abdominal X-ray can confirm the presence of the double bubble sign, aiding in the diagnosis of duodenal atresia.

Management

The management of conditions presenting with a double bubble sign typically involves surgical intervention. In the case of duodenal atresia, surgery is performed to bypass or open the atretic segment of the duodenum, allowing normal passage of intestinal contents.

Prognosis

With timely surgical intervention, the prognosis for infants with duodenal atresia is generally good. However, associated anomalies, such as Down syndrome, may affect overall outcomes.

Also see

• Duodenal atresia
• Annular pancreas
• Duodenal stenosis
• Malrotation
• Midgut volvulus