2019 Volume 55 Issue 1 Pages 120-124
We herein report two cases of congenital pyloric atresia (CPA). The first case involved a male infant born at 35 weeks of gestation, who had been prenatally diagnosed as having CPA by fetal ultrasonography when the mother underwent a check-up for polyhydramnios. The X-ray and upper gastrointestinal series, which were conducted on the first day after birth, also showed a single-bubble sign. An operation was performed on the second day after birth and membranous atresia was recognized at the pylorus. The second case involved a female infant who had been prenatally diagnosed as having congenital duodenal atresia (CDA) because fetal ultrasonography showed a double-bubble sign when the mother underwent a check-up for polyhydramnios. She was born at 39 weeks of gestation. The X-ray and upper gastrointestinal series, which were conducted on the first day after birth, also showed the double-bubble sign and intestinal malrotation. An operation was performed on the second day after birth. Membranous atresia was recognized at the pylorus, but not at the duodenum. A Ladd operation and membrane resection were performed. CPA is a rare congenital malformation of the gastrointestinal tract. Prenatal ultrasound, X-ray and an upper gastrointestinal series after birth are useful for the preoperative diagnosis. The single-bubble sign is a typical finding of CPA; however, the double-bubble sign is sometimes observed because of stomach contraction. Repeated prenatal ultrasound examinations are important for the exact diagnosis of CPA or CDA. When CDA is suspected, CPA should be considered as the differential diagnosis.
