A 23-day-old male infant was brought to the emergency department after 5 days of increasing vomiting. Physical exam revealed mild dehydration and an olive-sized abdominal mass. Upper gastrointestinal radiography showed a distended, air-filled stomach. What is the likely diagnosis? A) Gastric duplication B) Pyloric stenosis C) Duodenal atresia D) Intestinal malrotation E) Mid-gut volvulus

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C. Deudonal Atresia. Duodenal atresia is the congenital absence or complete closure of a portion of the lumen of the duodenum. It causes increased levels of amniotic fluid during pregnancy (polyhydramnios) and intestinal obstruction in newborn babies. Newborns with duodenal atresia will need an operation in order to fix the intestinal atresia. The goal of this surgery is to remove the bowel obstruction and allow the digestive tract to be functional. Your surgeon will wait until there are signs of good bowel function before starting to feed the baby.

Answer is Pyloric stenosis- Congenital hypertrophic pyloric stenosis. Points in favour - palation of an olive sized abdominal mass .There is no double bubble sign which is characteristically seen in Duodenal atresia

B) Congenital hypertrophic pyloric stenosis palpable pyloric tumor is sign qua non of congenital hypertrophic pyloric stenosis Dilated stomach confirms that diagnosis 'mild dehydration' again supports diagnosis of congenital hypertrophic pyloric stenosis. This is because the obstruction is not complete and it shows some content to pass through. therefore the 'mild dehydration', in other conditions of complete obstruction there will be severe dehydration. Once again duodenal atresia will present in day one of child birth, such infant will not survive up to 25 days of life without surgery. where as congenital hypertrophic pyloric stenosis is always a late presentation and it is absent at birth. there are various theories as to why it has delayed presentation. Therefore - B is correct answer

C) Duodenal atresia

Thanks Dr Pushkar Bhomia
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C duodenal atersia

Duodenal atresia “C” wherein deris “double bubble sign

C is rt

DUODENAL ATRESIA IS MORE LIKELY

SUGGESTIVE OF C DUODENAL ATRESIA

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