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Double Bubble Sign
- Radiographic signs describing two air-filled structures in the upper abdomen with little or no air distally
- Can be reproduced in upper GI study or ultrasound
- Left-sided bubble = stomach
- Right-sided bubble (usually right of midline) = duodenum
- Most common cause = duodenal atresia
Differential Diagnoses
- Intrinsic cause: duodenal atresia, duodenal stenosis, duodenal web
- Extrinsic cause: annular pancreas, malrotation with obstruction produced by midgut volvulus or by Ladd bands
Main Concern
- Must be differentiated from 'malrotation with obstruction (midgut volvulus)' because this condition requires urgent surgery
- Suspect midgut volvulus if stomach is distended but duodenum is normal or only slightly dilated
Reference:
Traubici J. The double bubble sign. Radiology 2001;220:463-464.
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