An exceptional cause of duodenal obstruction detected antenatally: A compressive preduodenal portal vein

The authors report a case of a duodenal obstruction with an antenatal ultrasound suggestive of a duodenal atresia. At birth, the newborn was symptoms free. 3 weeks later, she was admitted for persistent nonbilious vomiting. Laparotomy, performed with the diagnosis of duodenal stenosis, demonstrated a compressive preduodenal portal vein (PDPV) which was the primary cause of the duodenal obstruction. Despite its exceptional occurrence, a compressive PDPV must be included in the differential diagnosis of a congenital duodenal obstruction. Its embryological study is discussed to heighten awareness of its identification and avoid the potential surgical difficulties. The discussion also focuses on the pre and postnatal ultrasound features in the assessment of the diagnosis of a PDPV. The recommended surgical procedure is the loose overbridging duodenoduodenostomy