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July 1960

An Unusual Duodenal Diaphragm

Author Affiliations

U.S. Army
From the Surgical Service, 97th General Hospital, Frankfurt, Germany, APO 757, New York.

Am J Dis Child. 1960;100(1):127-128. doi:10.1001/archpedi.1960.04020040129020

Although congenital diaphragms of the gastrointestinal tract are not rare, the following case of duodenal diaphragm is reported because it presented such a confusing diagnostic problem.

Report of Case  A 6-month-old white boy was admitted to the 97th General Hospital, Frankfurt, Germany, with a history of vomiting and general malnutrition since birth. He was extremely thin and malnourished. He only slightly exceeded his birth weight.There was a prominent and tympanitic upper abdomen. No masses were palpable. An upright x-ray of the abdomen showed a "double bubble" stomach. There were two fluid levels of about equal size, one in the normal stomach position and another to the right and just below. Chronic and congenital duodenal obstruction was diagnosed, and the infant was taken to the operating room. At surgery, there was an enormously dilated first and second part of the duodenum, which was at least as large as the dilated

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