DrVirgo
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21. A full term neonate has repeated episodes of bilious green vomiting during the first day of life and does not pass any meconium. He was the product of a normal pregnancy, to a mother not known to have any major illness. Except for abdominal distention, the infant is normal on physical examination. X-Ray films show multiple air-fluid levels and distended loops of small bowel. A sweat test is normal. Which of the following is the most likely diagnosis?
A. Duodenal Atresia
B. Intestinal atresia
C. Intussusception
D. Meconium Ileus
E. Necrotizing enterocolitis
Explain please.
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| yasmeen
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D
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| DrVirgo
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Correct answer is B.
As I remember from Step 1, Pyloric Stenosis presents with non-bilious vomiting, and Duodenal Atresia presents with Bilious vomiting...
Now, what is the difference between DUODENAL Atresia, and INTESTINAL Atresia???
How can you tell the difference??? Why is the right answer intestinal atresia and NOT duodenal atresia???
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| paviraj
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is it due to x-ray findings?
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| DrVirgo
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anyone know how to differentiate between A and B?
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| paviraj
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-IN DUODENAL ATRESIA DOUBLE BUBBLE SIGN - GAS IN STOMACH & 1ST PART OF DUODENUM NOT MULTIPLE AIR - FLUID LEVELS.
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| webjeee
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multiple air-fluid levels and distended loops of small bowel, which indicates that the blockade must be in or below the small bowel level.
if Duodenal Atresia, blockade above Duodenal, then double bubble sign.
I think only Meconium Ileus can be diffrentiated though.
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| krsna
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duodnal atresia wud not have multiple airfluid levels
meconium ileus is assosiated with cystic fibrosis and the q mentions that sweat test is normal
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| hallachi
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Diffrence between duodenal and intestinal atresia..intestinal atresia means obst in small or large intestine in small intestine it cud be in ileum(more common) or jujenum or colonic in case of large intestinal atresia..
S/S...symptoms arrise right after birth , 1...bilous emesia..onset of vomiting depends on location of atresia..if obst in duodenum..soon after birth...while if it is in illeal then emesis can after 24 hours..
2..abdominal distension...in duodenal there is no abd distension while in intestinal positive abd distention ..and the degree of distension is depend on how near the distension is like atresia in illeum shows early abd dist Vs jujenal which apperas late.
on Xray..duodenal atresia shows double bubble sign..i.e air in stomach and proximal duodenum..
while With more proximal atresias, few air-fluid levels are evident with no apparent gas in the lower part of the abdomen. The more distal lesions demonstrate more air-fluid levels, although the distal intestine remain gas less
Although a plain radiograph can depict the presence of an obstruction, it is not the best method of showing the location of the abnormality. A barium enema may be used to define a microcolon indicative of a distal small-bowel obstruction; it is also capable of establishing the diagnosis of other causes of lower obstruction, such as Hirschsprung disease or a meconium plug. The contrast enema may also reflux into the small bowel and help define the level of a distal obstruction .
I hope it helps to make a diffrence between these two..
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| hallachi
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there are some x rays to determine intestinal atresia
Attached Files:
x-ray jujenal atresia.jpg (4 KB, 50 downloads)
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| hallachi
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colonic atresia ...barium contrast
Attached Files:
colonic atresia x ray.jpg (5 KB, 22 downloads)
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| hallachi
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dudenal atresia errect x ray film
Attached Files:
Duodenal%20atresia.jpg (15 KB, 23 downloads)
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| ram3
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The answer is chice a duodenal atresia with bilous vomitting meconium ileus can be eliminated by the normal sweat chloride test
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| MAGY17
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the as is INTESTINAL ATRESIA, ALSO SHOWS UP WITH GREEN VOMITING, BUT INSTEAD OF A DOUBLE BUBBLE (DUODENAL ATRESIA0 THERE ARE MULTIPLE AIR-FLUID LEVELS THROUGHOUT THE ABDOMEN
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| cirus
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The ans is Intest atresia, its a classic present (multiple air fluid levels)
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| ram3
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yes intestinal atresia
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