Answer:
Duodenal Web - Wind Sock Type
Findings:
Barium meal shows the distended and elongated web filled with barium. There is also a dimpling of duodenal contour at point of attachment of the web. CT shows distended stomach, 1st and 2nd parts of duodenum. The thin web can also be seen in multiple sections in the CT. The barium meal video shows the obstruction caused by the ballooned out elongated web inspite of the peristaltic movements.
Discussion:
Duodenal webs are usually seen in the pediatric population, though rarely they can present in adulthood. They usually occur in the 2nd part of duodenum at level of ampulla of Vater. They can either be a circumferential diaphragm in neonate or an redundant membrane ballooned out in the form of a 'windsock' in older child or adult. If it causes complete obstruction, double bubble sign can be seen simulating duodenal atresia. Treatment is surgery with resection of the web. In case of complete obstruction, duodenoduodenostomy is performed.
Contributed By:
Dr. Iyappan Ponnuswamy MD, FRCR, Consultant Radiologist
Dr. S. Ilango MS, MCh, Consultant Surgical Gastro Enterologist
Kauvery Hospital, Alwarpet, Chennai
Duodenal Web - Wind Sock Type
Findings:
Barium meal shows the distended and elongated web filled with barium. There is also a dimpling of duodenal contour at point of attachment of the web. CT shows distended stomach, 1st and 2nd parts of duodenum. The thin web can also be seen in multiple sections in the CT. The barium meal video shows the obstruction caused by the ballooned out elongated web inspite of the peristaltic movements.
Discussion:
Duodenal webs are usually seen in the pediatric population, though rarely they can present in adulthood. They usually occur in the 2nd part of duodenum at level of ampulla of Vater. They can either be a circumferential diaphragm in neonate or an redundant membrane ballooned out in the form of a 'windsock' in older child or adult. If it causes complete obstruction, double bubble sign can be seen simulating duodenal atresia. Treatment is surgery with resection of the web. In case of complete obstruction, duodenoduodenostomy is performed.
Contributed By:
Dr. Iyappan Ponnuswamy MD, FRCR, Consultant Radiologist
Dr. S. Ilango MS, MCh, Consultant Surgical Gastro Enterologist
Kauvery Hospital, Alwarpet, Chennai