Treatment of Preduodenal Portal Vein

Cardiac ultrasonography demonstrated a situs solitus and blood tests showed a positive sepsis profile; blood urea was raised, serum electrolytes were normal and blood culture was positive for extended-spectrum beta-lactamase producing Klebsiella. Ladd’s procedure with lysis of adherent band and appendectomy was performed. Because of the non-bilious nasogastric aspirates during 10 days at our unit, the quiescent malrotation and the compressing aspect of the preduodenal portal vein during laparotomy, we believed that the PDPV was involved in obstruction. A, abdominal and chest X-ray showing a right-sided stomach revealed by the nasogastric tube, a left-sided liver and consolidation of the Left Lung; B, intraoperative photograph showing the gallbladder (green arrow), oral side of the duodenum (white arrow), anal side of the duodenum (gray arrow) and the short preduodenal portal vein (blue arrow) compressing and tracting the duodenum. Anomalies associated with PDPV include biliary atresia, preduodenal common bile duct, cardiovascular malformations and...