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Duodenal atresia — RACP Paediatrics MCQ

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EasyGIDuodenal atresiaRACP Paediatrics

A term neonate develops bilious vomiting and abdominal distension on day 1. Abdominal X-ray shows a classic 'double bubble' sign with no distal gas. Antenatal ultrasound showed polyhydramnios. What is the most likely diagnosis?

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Correct answer: C — Duodenal atresia

A 'double bubble' sign (dilated stomach and proximal duodenum) with no distal gas indicates complete duodenal obstruction, most commonly duodenal atresia. Approximately 30% of infants with duodenal atresia have trisomy 21. Management is surgical (duodenoduodenostomy). NG decompression and IV fluids are required preoperatively.

Reference: RCH Melbourne – 2023 – Neonatal Bowel Obstruction CPG; RACP Paediatric Curriculum – Neonatology