DDX of duodenal obstruction

Approach to the DDX of duodenal obstruction:

  • In the neonate, consider
    Intrinsic causes – duodenal atresia via AXR and duodenal stenosis / duodenal web via upper GI
    Extrinsic causes – annular pancreas / preduodenal portal vein via US and malrotation with midgut volvulus via upper GI
  • In the patient with bilious vomiting consider malrotation with midgut volvulus via upper GI
  • In the patient with trauma consider duodenal hematoma via upper GI or US
  • In the patient with recent weight loss or who is post surgery for scoliosis correction consider superior mesenteric artery syndrome via upper GI