Related Experiment Video
Updated: Aug 5, 2026
14:19
Fetal Echocardiography and Pulsed-wave Doppler Ultrasound in a Rabbit Model of Intrauterine Growth Restriction
Published on: June 29, 2013
Prenatal double bubble with distal fluid: Not a marker for malrotation with volvulus
Caitlin J Cain-Trivette1, Christopher Nemeh1, Yeu Sanz Wu1
1Division of Pediatric Surgery, Department of Surgery, Columbia University Vagelos College of Physicians and Surgeons / NewYork-Presbyterian Morgan Stanley Children's Hospital, New York, NY, USA.
Journal of Neonatal-Perinatal Medicine
|July 31, 2026
Summary
The prenatal "double bubble" sign effectively identifies duodenal obstruction. Distal bowel fluid in fetuses with this sign does not indicate malrotation with volvulus, offering reassurance for expectant parents.
Area of Science:
- Medical Imaging
- Fetal Surgery
- Pediatric Surgery
Background:
- The prenatal "double bubble" (DB) sign indicates duodenal obstruction.
- Distal bowel fluid with the DB sign may suggest malrotation with volvulus.
Purpose of the Study:
- To evaluate if distal bowel fluid in fetuses with a prenatal DB sign is associated with malrotation or volvulus.
Main Methods:
- Retrospective review of 29 fetuses with a prenatal DB sign (Jan 2015-Dec 2025).
- Analysis of prenatal ultrasound, fetal MRI findings, operative diagnoses, and neonatal outcomes.
- Specific focus on distal bowel fluid presence on fetal MRI.
Main Results:
- Duodenal obstruction confirmed in 93.8% of neonates undergoing surgery.
- Distal bowel fluid on fetal MRI was not linked to malrotation with volvulus.
- Asymptomatic malrotation found in 5 infants; no midgut volvulus cases occurred.
Conclusions:
- Prenatal DB sign is a sensitive marker for duodenal obstruction.
- Distal bowel fluid on fetal MRI does not predict malrotation with volvulus.
- Findings support reassurance for patients with prenatal DB sign and distal fluid.
