Duodenal atresia differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

Duodenal atresia must be differentiated from other diseases that cause persistent vomiting, and feeding difficulties, such as volvulus, jejuno-ileal atresia, and malrotation.

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.

Preferred Table

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 inestine	Stomach distension and air fluid levels	Hypokalemia Hyperchloremia
Jejuno-ileal atresia	+	+	+/-	+	+	+	+	Gas in stomach with no gas in colon	Stomach and proximal small intestine distension	Hypokalemia Hyperchloremia
Volvulus	+	+	+/-	+	+	+	+	Malrotation of intestine	Malrotation of intestine with gas in stomach	Hypokalemia Hyperchloremia
Pyloric Stenosis	+	+	+/-	-	-	-	+	Pyloris is enlarged	-	Hypokalemia Hyperchloremia