Duodenal Web

  • Etiology: Congenital failure of recanalization
  • Imaging AXR: Air fluid levels in stomach and duodenal bulb (double bubble sign) with distal bowel gas
  • Imaging UpperGI: Incomplete duodenal obstruction by intraluminal diaphragm causing a windsock deformity
  • DDX: Duodenal atresia, duodenal stenosis
  • Complications:
  • Treatment: Surgical
  • Clinical:
    — Less severe form of duodenal atresia which often results in a delayed diagnosis
    — More common in patients with Trisomy 21

Radiology Cases of Duodenal Web

UGI of duodenal web
Image from an upper GI exam shows a wind-sock deformity at the junction of the second and third portions of the duodenum.
AXR and upper GI of duodenal web
AXR AP (above) shows a double bubble sign with a dilated stomach to the left of the spine and a dilated duodenum to the right of the spine. Oblique images from an upper GI show a dilated duodenal bulb projecting over the vertebral bodies (lower right) and a small amount of contrast entering the second part of the duodenum (lower left).