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Duodenal atresia with gas below the obstruction

The Children's Hospital, Birmingham

Three babies with duodenal atresia are described where there was gas visible below the obstruction in radiographs of the abdomen. The gas had by-passed the complete obstruction via the hepato-pancreatic duct, which had a double termination with one orifice on each side of the atresia.

A bifid termination of the hepato-pancreatic duct has been reported as a normal but temporary embryological event that may be related to the development of duodenal atresia.

The passage of gas by-passing the atresia is unlikely to be sufficient to mask the radiological diagnosis of a duodenal obstruction, but it may give a misleading impression that the obstruction is partial when there is really a complete interruption of the duodenal lumen.

Received for publication September 1, 1968.