Late Presentation of a Duodenal Obstruction in a Child with Failure to Thrive and Abdominal Pain

Introduction

A pre-duodenal portal vein (PDPV) is a very rare but known entity. It is usually incidentally discovered when undergoing pancreatic surgery and is frequently associated with polysplenia. Less than 100 cases have been described in the literature from which around 1.8% also had concomitant malrotation (Vilakazi M et al., Afr J Paediatr Surg 2014; 11: 359–361; Mordehai J et al., J Pediatr Surg 2002; 37: E5). When this anomaly causes obstruction, it is usually diagnosed and treated during the neonatal period. To our knowledge, this is the first case reported in which a PDPV was the only cause found for a chronic gastric outlet obstruction in a patient with nonrotation (Brandt ML, UpTo-Date. com. 2011).