Duodenal Atresia / Hypovolemic Shock: A Case for High-Fidelity Simulation in Emergency Medicine

Format Publication ID Version Published
Case 8505 1 June 20, 2011
Wake Forest University School of Medicine


This high-fidelity patient simulation case involves a 3 day old child with a diagnosis of duodenal atresia. Evaluation in the emergency department demonstrates a severely dehydrated neonate with a history of greenish/yellow emesis. Appropriate treatment with IV fluids will allow stabilization of the patient. Residents will also have to discuss the patient’s disposition with an attending pediatric surgeon. Debriefing materials are provided to illustrate and stimulate discussion of the important concepts for diagnosing and treating patients’ duodenal atresia and bilious emesis.


O'Neill J, Fitch M. Duodenal Atresia / Hypovolemic Shock: A Case for High-Fidelity Simulation in Emergency Medicine. MedEdPORTAL; 2011. Available from: www.mededportal.org/publication/8505

Educational Objectives

A. Primary Learning Objectives:

  1. To demonstrate an appropriate initial approach for a patient with hypovolemic shock and duodenal atresia.
  2. To identify and treat hypovolemic shock.
  3. To recognize a “double bubble” sign on radiograph.
  4. To list the diagnostic features of duodenal atresia.
  5. To understand the treatment of duodenal atresia with possible malrotation.

B. Secondary Goals:

  1. To differentiate between different causes of vomiting in a neonate.
  2. To understand the pathophysiology of duodenal atresia.
  3. To illustrate the emergency department disposition for a neonate with bilious emesis.


  • Duodenal Atresia, Duodenal Obstruction (MeSH), Hypovolemic Shock, Intestinal Volvulus (MeSH), Newborn Infant (MeSH)


  • Medical
    • Neonatal-Perinatal Medicine
    • Pediatric Emergency Medicine

Competencies Addressed

  • Medical
    • Medical Knowledge
    • Patient Care
    • Systems-based Practice

Academic Focus

  • Clinical Sciences
    • Clinical Exam
    • Clinical Skills/Doctoring

Professional Interest

  • Evaluation of Clinical Performance
  • Instructional Materials/Methods

Intended Audience

  • Professional School
    • Medical Student
  • Professional School Post-Graduate Training
    • Fellow
    • Resident

Instructional Methods

  • Problem-based Learning
  • Simulation

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