Approach to differential diagnosis of gastrointestinal atresia:
- Failure to pass a nasogastric tube is due to esophageal atresia
- A double bubble sign on AXR is nearly always due to duodenal atresia
- Several dilated loops of jejunum – a triple bubble sign – without distal gas should be due to jejunal atresia which can be confirmed by an upper GI exam
- Ileal atresia has a microcolon on enema without meconium pellets, and the terminal ileum cannot be refluxed
- Colonic atresia has a microcolon on enema that is shortened in length
- In anorectal malformation an enema cannot be done
Pediatric Imaging 