Clinical Presentation

A neonate with persistent vomiting.

(A,B) Frontal chest and abdominal radiographs demonstrate gaseous dilatation of the stomach and duodenum with no gas distal to this point in the gastrointestinal tract, a pattern that is often referred to as a “double bubble” (arrows).

Differential Diagnosis

• Duodenal atresia: The findings of a dilated stomach and duodenum with a complete absence of distal bowel gas are classic for duodenal atresia.

• Malrotation with midgut volvulus: