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CASE REPORT
Year : 2022  |  Volume : 19  |  Issue : 2  |  Page : 109-111

Duodenal obstruction due to missed pre-duodenal portal vein in a patient with intestinal malrotation


1 Department of Surgery, College of Medicine, Kaduna State University and Barau Dikko Teaching Hospital; Department of Surgery, Epsilon Specialist Hospital, Barnawa, Kaduna, Nigeria
2 Department of Surgery, Epsilon Specialist Hospital, Barnawa, Kaduna, Nigeria
3 Department of Surgery, College of Medicine, Kaduna State University and Barau Dikko Teaching Hospital, Kaduna, Nigeria

Correspondence Address:
Dr. Stephen Akau Kache
Department of Surgery, College of Medicine, Kaduna State University and Barau Dikko Teaching Hospital, Kaduna
Nigeria
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ajps.AJPS_146_20

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Pre-duodenal portal vein (PDPV) is a rare anomaly and a rare cause of duodenal obstruction (DO), with only a few cases reported in the literature. We present an infant whose bilious vomiting persisted despite having Ladd's procedure for intestinal malrotation due to a missed diagnosis of DO from PDPV that was found at re-exploration. The patient was diagnosed with malrotation and had Ladd's procedure at 12 weeks of age, but bilious vomiting persisted post-operatively. The patient presented to us after 4 weeks, was clinically malnourished and dehydrated, resuscitation was done and re-exploratory laparotomy performed, where an obstructing PDPV was found and a duodeno-duodenostomy was performed anterior to PDPV. However, the patient died on post-operative day 7 probably from severe malnutrition due to delayed diagnosis and absence of parenteral nutrition. We conclude that PDPV may be a cause of DO in infants with malrotation and should be properly sought for during Ladd's procedure for possible bypass surgery if found.


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