Preduodenal Portal Vein Associated With Intestinal Malrotation and Jejunal Atresia

Abstract

Preduodenal portal vein (PDPV) is a rare congenital anomaly commonly associated with other gastrointestinal abnormalities. We report the case of a female neonate with a PDPV, intestinal malrotation and jejunal atresia. This is the second account of this association reported in the literature. The previously reported case underwent a gastroduodenostomy to correct the presumed duodenal obstruction caused by the PDPV. In our case, the PDPV was not corrected and the child remains well and asymptomatic. We propose that in this rare association, the PDPV is not a cause of obstruction and does not need correction.

Keywords: duodenal obstruction; jejuna atresia; malrotation; neonatal bowel obstruction; preduodenal portal vein.

Figure 1. Antenatal ultrasound at 31/40 gestation showing normal calibre of distal bowel with dilated proximal bowel loops

Figure 2. Intraoperative photograph demonstrating the initial finding of a Type II jejunal atresia (A)

Figure 3. Malrotation and the preduodenal portal vein crossing anterior to the second part of the duodenum (B) were also identified at laparotomy