3. CASE ONE What are the findings ? Supine radiograph of the abdomen of an infant shows two prominent gas distended viscus in the upper abdomen c/w dilated stomach and duodenum. Lack of bowel gas in distal bowel What is your diagnosis? Duodenal atresia – Double bubble sign with lack of distal bowel gas is diagnostic What are the differentials ? With a dilated stomach and duodenum and some gas in distal bowel, D/D include stenosis,Ladd’s bands,annular pancreas, duodenal web, malrotation, preduodenal portal vein, duplication cyst
4. CASE ONE What are the associations of duodenal atresia ? Seen in 50-60% - Down’s, CHD, vertebral &rib anomalies, GI anomalies What are associated findings on an infantogram ? Eleven pairs of ribs & altered iliac index (Down’s); rib & vertebral anomalies, L- R shunt ( always look for features of Down’s in a pt with double bubble )
6. CASE TWO What are the salient findings ? Lateral skull radiograph of a child : - flocculent calcification in the sellar & suprasellar region with sellar enlargement, - enlarged cranium & sutural diastasis - pneumoventricle ( post pneumoencephalography) What is the diagnosis ? How would you confirm your diagnosis ? Craniopharnygioma – sellar and suprasellar calcification in a child suggests the diagnosis MRI Brain / CECT head f/b HPE
7. CASE TWO What would you expect to see on CT/ MRI ? CT - Mixed solid cystic suprasellar mass with calcifications and obstructive hydrocephalus. MRI – MC hyperintense, MB iso/hypo on T1; hyper on T2, solid components may enhance Related topics : D/d sellar/ suprasellar masses in child Causes of intracranial calcification in child
8. CASE THREE Q. What are the findings of X ray ? Reduction in L5 height, tear drop fracture antero-inferior body
