Hexadactyly , short tubularbones and cone shaped
Absent lateral proximal tibial epiphyses
Dome shaped metaphyses
Complete congenital intrinsic obstruction of the duodenum.
Result from failed recanalization.
Associations: Downs, Polyhydromnios
Plain-film: double-bubble sign is diagnostic (gaseous distention of the stomach and an enlarged duodenal bulb or mega bulb).
No intestinal gas is seen distal to the duodenum
Contrasted swallow not indicated.
Distal gas requires further investigation for other etiologies of neonatal duodenal obstruction
– duodenal stenosis or web,
– malrotation with Ladd’s bands or volvulus,
– annular pancreas, or
– duplication cyst