Duodenal atresia differential diagnosis

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.

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 Hyperchloremia	Down syndrome
Jejuno-ileal atresia	+	+	+/-	+	+	+	+	Gas in stomach with no gas in colon	Stomach and proximal small intestine distension	Hypokalemia Hyperchloremia
Volvulus	+	+	+/-	+	+	+	+	Spiral sign	Malrotation of intestine with gas in stomach and air fluid levels	Hypokalemia Hyperchloremia
Meconium ileus	+	+	+/-	+	+	+	+	Distension	Air fluid levels	Hypokalemia Hyperchloremia	Cystic fibrosis