The 'double bubble' sign on plain abdominal radiograph in a neonate is pathognomonic of:

• A Midgut volvulus
• B Meconium ileus
• C Annular pancreas with partial obstruction
• D Duodenal atresia ✓

Explanation

The double bubble sign on plain X-ray shows two air-fluid levels — one in the dilated stomach and one in the dilated proximal duodenum — with absence of distal bowel gas, indicating complete duodenal obstruction. Duodenal atresia is the most common cause and accounts for 1 in 5000-10000 births. It is associated with Down syndrome in 25–30% of cases. Annular pancreas can also cause double bubble if obstruction is complete, but the term is classically applied to duodenal atresia. Treatment is duodenoduodenostomy.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.