Revision 2 for 'Preduodenal portal vein'

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Preduodenal portal vein

Preduodenal portal vein (PDPV) is a rare congenital vascular disorder resulting in the portal vein main trunk passing anteriorly to the duodenum 1.

Etiology

The precise etiology is unknown, however it occurs due to incorrect formation of the foetal vitelline veins 2

Associations

Preduodenal portal vein is often part of a heterotaxia syndrome or polysplenia syndrome or associated with 3:

  • Situs inversus
  • Malrotation
  • Biliary atresia
  • Duodenal atresia
  •  Annular pancreas

Clinical presentation

In approximately 50% of patients, PDPV was found incidentally through laparotomy or imaging for other reasons 4.

If patients have symptoms, they are generally pediatric and present with symptoms of duodenal obstruction 4

Imaging findings

CT with contrast: will show the main truck of the portal vein tracking anterior to the duodenum. 

Treatment 

Treatment of PDPV induced duodenal obstruction is through bypass surgery, either with gastroduodenostomy or duodenoduodenostomy 5

 

 

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