Duodenal atresia differential diagnosis: Difference between revisions
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[[Image:Home_logo1.png|right|250px|link=https://www.wikidoc.org/index.php/Duodenal_atresia]] | |||
{{CMG}}; {{AE}} {{HQ}} | {{CMG}}; {{AE}} {{HQ}} | ||
==Overview== | ==Overview== | ||
Duodenal atresia must be differentiated from other diseases that cause persistent vomiting, and feeding difficulties, such as volvulus, jejuno-ileal atresia, malrotation, and meconium ileus. It is differentiated based on imaging. | Duodenal atresia must be differentiated from other diseases that cause persistent [[Nausea and vomiting|vomiting]], and [[Dysphagia|feeding difficulties]], such as [[volvulus]], jejuno-ileal atresia, [[Intestinal malrotation|malrotation]], and [[meconium ileus]]. It is differentiated based on imaging. | ||
==Differentiating duodenal atresia from other Diseases== | ==Differentiating duodenal atresia from other Diseases== | ||
*Duodenal atresia must be differentiated from other diseases that cause persistent vomiting, and feeding difficulties, such as volvulus, jejuno-ileal atresia, and malrotation.<ref name="AdamsStanton2014">{{cite journal|last1=Adams|first1=Stephen D.|last2=Stanton|first2=Michael P.|title=Malrotation and intestinal atresias|journal=Early Human Development|volume=90|issue=12|year=2014|pages=921–925|issn=03783782|doi=10.1016/j.earlhumdev.2014.09.017}}</ref><ref name="MorrisKennedy2016">{{cite journal|last1=Morris|first1=Grant|last2=Kennedy|first2=Alfred|last3=Cochran|first3=William|title=Small Bowel Congenital Anomalies: a Review and Update|journal=Current Gastroenterology Reports|volume=18|issue=4|year=2016|issn=1522-8037|doi=10.1007/s11894-016-0490-4}}</ref><ref name="pmid10821158">{{cite journal| author=Kimura K, Loening-Baucke V| title=Bilious vomiting in the newborn: rapid diagnosis of intestinal obstruction. | journal=Am Fam Physician | year= 2000 | volume= 61 | issue= 9 | pages= 2791-8 | pmid=10821158 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10821158 }} </ref> | *Duodenal atresia must be differentiated from other diseases that cause persistent [[vomiting]], and feeding difficulties, such as [[volvulus]], jejuno-ileal atresia, and [[Intestinal malrotation|malrotation]].<ref name="AdamsStanton2014">{{cite journal|last1=Adams|first1=Stephen D.|last2=Stanton|first2=Michael P.|title=Malrotation and intestinal atresias|journal=Early Human Development|volume=90|issue=12|year=2014|pages=921–925|issn=03783782|doi=10.1016/j.earlhumdev.2014.09.017}}</ref><ref name="MorrisKennedy2016">{{cite journal|last1=Morris|first1=Grant|last2=Kennedy|first2=Alfred|last3=Cochran|first3=William|title=Small Bowel Congenital Anomalies: a Review and Update|journal=Current Gastroenterology Reports|volume=18|issue=4|year=2016|issn=1522-8037|doi=10.1007/s11894-016-0490-4}}</ref><ref name="pmid10821158">{{cite journal| author=Kimura K, Loening-Baucke V| title=Bilious vomiting in the newborn: rapid diagnosis of intestinal obstruction. | journal=Am Fam Physician | year= 2000 | volume= 61 | issue= 9 | pages= 2791-8 | pmid=10821158 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10821158 }} </ref> | ||
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| style="background: #F5F5F5; padding: 5px;" |Gas in stomach with absent gas in small intestine | | style="background: #F5F5F5; padding: 5px;" |[[Gas]] in [[stomach]] with absent [[gas]] in [[small intestine]] | ||
| style="background: #F5F5F5; padding: 5px;" |Stomach distension and air fluid levels | | style="background: #F5F5F5; padding: 5px;" |[[Stomach]] [[distension]] and air fluid levels | ||
Double bubble sign | Double bubble sign | ||
| style="background: #F5F5F5; padding: 5px;" |Hypokalemia | | style="background: #F5F5F5; padding: 5px;" |[[Hypokalemia]] | ||
Hyperchloremia | [[Hyperchloremia]] | ||
| style="background: #F5F5F5; padding: 5px;" |Down syndrome | | style="background: #F5F5F5; padding: 5px;" |[[Down syndrome]] | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Jejuno-ileal atresia | | style="background: #DCDCDC; padding: 5px; text-align: center;" |Jejuno-ileal atresia | ||
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| style="background: #F5F5F5; padding: 5px;" | + | | style="background: #F5F5F5; padding: 5px;" | + | ||
| style="background: #F5F5F5; padding: 5px;" |Gas in stomach with no gas in colon | | style="background: #F5F5F5; padding: 5px;" |[[Gas]] in [[stomach]] with no gas in [[Colon (anatomy)|colon]] | ||
| style="background: #F5F5F5; padding: 5px;" |Stomach and proximal small intestine distension | | style="background: #F5F5F5; padding: 5px;" |[[Stomach]] and proximal [[small intestine]] [[distension]] | ||
| style="background: #F5F5F5; padding: 5px;" |Hypokalemia | | style="background: #F5F5F5; padding: 5px;" |[[Hypokalemia]] | ||
Hyperchloremia | [[Hyperchloremia]] | ||
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|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Volvulus | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Volvulus]] | ||
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| style="background: #F5F5F5; padding: 5px;" |Spiral sign | | style="background: #F5F5F5; padding: 5px;" |Spiral sign | ||
| style="background: #F5F5F5; padding: 5px;" |Malrotation of intestine with gas in stomach and air fluid levels | | style="background: #F5F5F5; padding: 5px;" |[[Intestinal malrotation|Malrotation]] of intestine with [[gas]] in [[stomach]] and air fluid levels | ||
| style="background: #F5F5F5; padding: 5px;" |Hypokalemia | | style="background: #F5F5F5; padding: 5px;" |[[Hypokalemia]] | ||
Hyperchloremia | [[Hyperchloremia]] | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Meconium ileus | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Meconium ileus]] | ||
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| style="background: #F5F5F5; padding: 5px;" |Distension | | style="background: #F5F5F5; padding: 5px;" |[[Distension]] | ||
| style="background: #F5F5F5; padding: 5px;" |Air fluid levels | | style="background: #F5F5F5; padding: 5px;" |Air fluid levels | ||
| style="background: #F5F5F5; padding: 5px;" |Hypokalemia | | style="background: #F5F5F5; padding: 5px;" |[[Hypokalemia]] | ||
Hyperchloremia | [[Hyperchloremia]] | ||
| style="background: #F5F5F5; padding: 5px;" |Cystic fibrosis | | style="background: #F5F5F5; padding: 5px;" |[[Cystic fibrosis]] | ||
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{{WS}} | {{WS}} | ||
[[Category: | [[Category:Gastroenterology]] | ||
[[Category:Surgery]] | |||
[[Category:Disease]] | |||
[[Category:Pediatrics]] | |||
[[Category:Up-To-Date]] | |||
Latest revision as of 20:36, 13 February 2019
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hamid Qazi, MD, BSc [2]
Overview
Duodenal atresia must be differentiated from other diseases that cause persistent vomiting, and feeding difficulties, such as volvulus, jejuno-ileal atresia, malrotation, and meconium ileus. It is differentiated based on imaging.
Differentiating duodenal atresia from other Diseases
- Duodenal atresia must be differentiated from other diseases that cause persistent vomiting, and feeding difficulties, such as volvulus, jejuno-ileal atresia, and malrotation.[1][2][3]
| Diseases | History and Symptoms | Physical Examination | Laboratory Findings | Other Findings | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Vomiting | Feeding difficulty | Stool present | Bilious vomitus | Abdominal distension | Abdominal tenderness | Dehydrated | Abdominal ultrasound | Abdominal x-ray | Electrolytes | ||
| Duodenal Atresia | + | + | +/- | + | +/- | + | + | Gas in stomach with absent gas in small intestine | Stomach distension and air fluid levels
Double bubble sign |
Hypokalemia | Down syndrome |
| Jejuno-ileal atresia | + | + | +/- | + | + | + | + | Gas in stomach with no gas in colon | Stomach and proximal small intestine distension | Hypokalemia | |
| Volvulus | + | + | +/- | + | + | + | + | Spiral sign | Malrotation of intestine with gas in stomach and air fluid levels | Hypokalemia | |
| Meconium ileus | + | + | +/- | + | + | + | + | Distension | Air fluid levels | Hypokalemia | Cystic fibrosis |
References
- ↑ Adams, Stephen D.; Stanton, Michael P. (2014). "Malrotation and intestinal atresias". Early Human Development. 90 (12): 921–925. doi:10.1016/j.earlhumdev.2014.09.017. ISSN 0378-3782.
- ↑ Morris, Grant; Kennedy, Alfred; Cochran, William (2016). "Small Bowel Congenital Anomalies: a Review and Update". Current Gastroenterology Reports. 18 (4). doi:10.1007/s11894-016-0490-4. ISSN 1522-8037.
- ↑ Kimura K, Loening-Baucke V (2000). "Bilious vomiting in the newborn: rapid diagnosis of intestinal obstruction". Am Fam Physician. 61 (9): 2791–8. PMID 10821158.