నియోనాటల్ బయాలజీ జర్నల్

నైరూప్య

Atypical Double-Bubble in MRI of a Fetus with Double Atresia Involving Esophagus and Jejunum

Yutaka Uzuki , Kazutoshi Cho, Shohei Honda , Sorahiko Fujisawa , Akinobu Taketomi, Mamoru Morikawa and Hisanori Minakami

Double-bubble sign is seen in fetuses with various alimentary tract obstructions, and typically with duodenal atresia. Atypically enlarged and clear double-bubble with enlarged distal esophagus on MRI was observed in a fetus with polyhydramnios at gestational week (GW) 27 suggesting double atresia of the esophagus and duodenum. Postnatal investigations and surgical procedures performed in this otherwise healthy male neonate weighing 2794 g at GW 36 revealed double atresia involving the esophagus (no fistula to trachea) and proximal jejunum. He transiently required tracheal intubation because an increased intra-abdominal pressure caused insufficient respiration. Following surgical repair, the patient left hospital at 69 days of age with excellent clinical course. Differential diagnoses should include a rare anomaly of double atresia in the esophagus and proximal jejunum in infants with double-bubble sign.