Paediatric surgery: duodenal atresia: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Paediatric surgery: duodenal atresia

Sample item

A newborn with upslanting palpebral fissures and a single palmar crease vomits bilious fluid on day one. Radiograph shows a double bubble with no distal gas. What is the operation of choice?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Duodenoduodenostomy

Duodenal atresia presents with early bilious vomiting and the double bubble sign (distended stomach and proximal duodenum) with a gasless distal bowel. It is strongly associated with Down syndrome, and with polyhydramnios on antenatal scans. Treatment is duodenoduodenostomy, usually diamond-shaped, after resuscitation and cardiac evaluation.

Option by option

  • A. Ladd procedure

    Ladd procedure treats malrotation and volvulus.

  • B. Duodenoduodenostomy (correct)

    Correct. Direct anastomosis bypasses the atretic segment.

  • C. Gastrojejunostomy

    Gastrojejunostomy causes blind loop and marginal ulcer problems and is not preferred.

  • D. Ramstedt pyloromyotomy

    Pyloromyotomy treats hypertrophic pyloric stenosis.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is B, Duodenoduodenostomy. Duodenal atresia presents with early bilious vomiting and the double bubble sign (distended stomach and proximal duodenum) with a gasless distal bowel.

Why is "Ladd procedure" not the answer?

Ladd procedure treats malrotation and volvulus.

Why is "Gastrojejunostomy" not the answer?

Gastrojejunostomy causes blind loop and marginal ulcer problems and is not preferred.

Why is "Ramstedt pyloromyotomy" not the answer?

Pyloromyotomy treats hypertrophic pyloric stenosis.

What concept does this question test?

It tests Paediatric surgery: duodenal atresia in General Surgery. It is strongly associated with Down syndrome, and with polyhydramnios on antenatal scans. Treatment is duodenoduodenostomy, usually diamond-shaped, after resuscitation and cardiac evaluation.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Paediatric surgery: duodenal atresia?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.