Biliary Tract Abnormalities As A Cause Of Distal Bowel Gas In Neonatal Duodenal Atresia

Background. The presence of distal bowel gas in an infant does not exclude the diagnosis of duodenal atresia. Case Presentation. We report a term neonate with Down syndrome. The infant developed vomiting and cyanosis with each feeding soon after birth. Plain film abdominal X-rays showed a nonspecific gas-filled stomach and small bowel. Duodenal atresia and an anomalous common bile were noted on an upper GI study and exploratory laparotomy. Conclusion. In the absence of a "double bubble" appearance and intestinal gas distally on a plain radiograph, one must not exclude duodenal atresia as the differential diagnosis.