Full-text resources of PSJD and other databases are now available in the new Library of Science.
Visit https://bibliotekanauki.pl


Preferences help
enabled [disable] Abstract
Number of results
2014 | 4 | 2 | 29-33

Article title

Duodenal obstruction in prenatal ultrasound examinations - duodenal atresia versus annular pancreas - reports on two cases and literature review


Title variants

Languages of publication



Obstruction of the duodenum is the most common intestinal obstruction of the fetus and newborn. A typical symptom of duodenal atresia is the double bubble sign. However, in order to diagnose annular pancreas, it is also required to locate a hyperechogenic band around the double bubble. We analysed the possibility of prenatal differential diagnosis of intestinal atresia, such as duodenal atresia and annular pancreas based on the analysis of two cases examined in the 26th week of pregnancy. This material was analysed by two ultrasonographers (one pediatric surgeon). Conclusions: "Double bubble" symptom in prenatal sonography is typical of high level intestinal obstruction, but it can occur both in classical duodenal atresia, and in the cases of annular pancreas, and in other rare anomalies. Classic prenatal ultrasound examination using 2D option seems to be insufficient for accurate differential diagnosis.









Physical description


1 - 6 - 2014
25 - 6 - 2014
26 - 4 - 2014
30 - 12 - 2015


  • Paediatric Surgery Clinic at the Upper Silesian Child Health Centre in Katowice
  • Prenatal Cardiology Department of the Polish Mother's Memorial Hospital
  • Department for the Diagnosis and Prevention of Congenital Defects at the Medical University of Lodz


  • 1. Pariente G, Landau D, Aviram M, Hershkovitz R. PrenPariente G, Landau D, Aviram M, Hershkovitz R. Prenatal Diagnosis of a Rare Sonographic Appearance of Duodenal Atresia. Report of 2 cases and literature review. J Ultrasound Med 2012;31:1829-1833
  • 2. Jeng Hsiu Hung, Shu Huei Shen, Tai Wai Chin, Chi Yi Selena Hung. Letters to the editor . Prenatal diagnosis of double duodenal atresia by ultrasound and magnetic resonance image. Prenat Diagn 2000; 27: 380-387.[WoS]
  • 3. Choudhry MS, Rahman N, Boyd P, Lakhoo K. Duodenal atresia: associated anomalies, prenatal diagnosis and outcome. Pediatr Surg Int 2009; 25: 727-730.[Crossref]
  • 4. Danovcik R, Jirasek JE, Kucera E, Feyereisl J, Radonak J, Dudas M. Prenatal diagnosis of annular pancreas: reliability of the double bubble sign with periduodenal hyperechogenic band. Fetal Diagn Ther 2008; 24:483-490.[Crossref][WoS]
  • 5. Cuillier F, Maurel A, MIchel JL, Alessandri JL. Duodenal atresia. Cuillier www thefetus.net 2006-06-12-11
  • 6. Ajit SA, Tushar W, Pradip JJ, Prakash V. Prenatal diagnosis of duodenal atresia by Ultrasound. Indian J Pediatr. 1991; 58: 145-147.[Crossref]
  • 7. Fonkalsrud EW, de Lorimer AA, Hays DM. Congenital atresia and stenosis of the duodenum , a review compiled from the members of the surgical section. Am Acad Pediatr 1969; 43: 79-83.
  • 8. Sugimoto T, Yamagiwa I, Obata K, Ouchi T, Takahashi R, Suzuki R, Shimazaki Y. Choledochal cyst and duodenal atresia: A rare combination of malformations. Pediatr Surg Int. 2004; 20(9): 724-726.[Crossref][WoS]
  • 9. Pameijer CR, Hubbard AM, Coleman B, Flake AW. Combined pur esophageal atresia, duodenal atresia, biliary atresia, and pancreatic ductal atresia: Prenatal diagnostic Features and review of the Literature. J Pediatr Surg 2000; 35(5): 745-747.[Crossref]
  • 10. Yadav CM, Yadav RP, Krishnanand BR. In utero diagnosis of duodenal atresia. Journal of Nepal Medical association, 2001; 41: 271-273.
  • 11. Hulvat MC, Kumar RB, Newman BM, Muraskas Jk. Annular pancreas in identical twin newborns. J Pediatr Surg 2006; 41: 19-21.[Crossref]
  • 12. Hemming V, Rankin J. Small intestinal atresia in a defined population: occurrence, prenatal diagnosis and survival. Prenat Diang 2007; 27: 1205-1211.[Crossref]
  • 13. Whelan IJ, Hamilton GB. Annular pancreas. Ann Surg 1957; 146: 252-262.[Crossref]
  • 14. Ravitch MM: The pancreas in infants and children. Surg Clin North Am 1975: 55; 377-385.
  • 15. Sanchez MA. Duodenal atresia. Sanchez www.thefetus.net/2006-05-22-10
  • 16. Ruth BD. Ultrasound evaluation of fetal abdomen. In: Callen‘s Ultrasonography in Obstetrics and Gynaecology, 3rd edn: W. B. Saunders Company 1994; 16: 347-369.
  • 17. Boomsma JH, Weemhoff RA, Polman Ha. Sonographic appearance of annular pancreas in utero: a case report. Diagn Imaging 1982; 51: 288-290.
  • 18. Loveday BJ, Barr JA, Aitken J. The intrauterine demonstration of duodenal atresia by ultrasound. Br J Radiol. 1975; 48: 1031.[Crossref]
  • 19. Zimmer EZ, Bronshtein M. Early diagnosis of duodenal atresia and possile sonographic pitfalls. Prenatal diagn 1996;16: 564-566.
  • 20. Ritchie CJ, Edward WS, Mack LA, et al. Three dimensional ultrasonic angiography using power-mode Doppler. Utrasound Med Biol 1996; 22: 277.[Crossref]
  • 21. Obata-Yasuoka M, Hamada H, Ohara R, Nakao A, Miyazono Y, Yoshikawa H. Alveolar capillary dysplasia associated with duodenal atresia: ultrasonographic findings of enlarged, highly echogenic lungs and gastric dilatation in a third-trimestr fetus. J Obstet Gynaecol Res 2011; 37: 937-939.[WoS][Crossref]
  • 22. Dewbury KC, Alawihare APR, Birch SJ. Prenatalultrasound demonstration of a choledochal cyst. Br J Radiol 1980; 53: 906.[Crossref]
  • 23. Malone FD, Croinleholme TM, Nores JA, D’ Alton ME. Pitfalls of the ‚double bubble’ sign: a caseof congenital duodenal duplication. Fetal Diag Ther 1997; 12: 298-300.[Crossref]
  • 24. Garne E, Loane M, Dolk H, and a Eurocat working group. Gastrointestinal malformation: impact of prenatal diagnosis on gestational age at birth. Paediatr Perinat Epidemiol 2007; 21(4): 370-375.[Crossref][WoS]
  • 25. Dankovcik R, Muranska S, Kucera E, Jirasek JE, Feyereisl J, Sudak M, Dudas M. Prenatal three-dimensional sonographic findings associated with annular pancreas. Fetal Diagn Ther 2010: 27: 57-60.[WoS]
  • 26. Tsukerman GL, Krapiva GA, Kirillowa IA: Firt-trimestr diagnosis of duodenal stanosis associated with oesophagel atresia. Prenat Diagn 1993; 13: 371-376.[Crossref]
  • 27. Lees RF, Alford BA, Brenbridge N, Buschi AJ, Williamson BR. Sonographic appearance of duodenal atresia in utero - case reports. Am J Roentgenol 1978; 131: 701-702. [Crossref]

Document Type

Publication order reference


YADDA identifier

JavaScript is turned off in your web browser. Turn it on to take full advantage of this site, then refresh the page.