Double bubble sign
PaediatricRadiograph / Antenatal US
Two rounded gas- (or fluid-) filled structures, the distended stomach and proximal duodenum, with little or no distal gas.
What it means
Proximal duodenal obstruction, classically duodenal atresia in the neonate.
Mechanism
Obstruction at the second part of the duodenum distends the stomach and duodenal bulb, which are separated by the pylorus.
Associated conditions
- Duodenal atresia
- Annular pancreas
- Duodenal web or stenosis
- Malrotation with Ladd bands
Pearls
- Duodenal atresia is strongly associated with Down syndrome.
- Distal gas should prompt concern for malrotation with volvulus rather than atresia.
References
- Radiopaedia: Double bubble sign
For educational use only. This dictionary is a study aid and reference, not a diagnostic tool, and must not be used to guide clinical decisions or patient care. Imaging appearances vary; always correlate with the full clinical picture and confirm with a qualified radiologist.