Preduodenal portal vein

The main causes for a double bubble are duodenal atresia, annular pancreas, and midgut volvulus. Less frequently it may be secondary to duodenal web, Ladd s band, or preduodenal portal vein (Crowe and Sumner 1978). 

Partial duodenal obstruction may be produced by duodenal stenosis, duodenal web, Ladd s bands, midgut volvulus, annular pancreas, preduodenal portal vein, and duplication cyst. Plain radiographs show gaseous distension of the stomach and duodenum with a normal or diminished quantity of air in the small bowel. Content studies may be necessary to differentiate between midgut volvulus and partial duodenal obstruction caused by a web or stenosis (Auringer and Sumner 1994). Sonography is helpful to rule out extraluminal causes such as a duplication cyst. 

Other congenital anomalies such as polysplenia, midline liver, interrupted inferior vena cava, situs inversus, preduodenal portal vein, and intestinal... 

Intestinal Malrotation 168 Duodenal Diverticulum 169 Duodenal Duplication 169 Preduodenal Portal Vein 170 Inflammatory Diseases 170 Peptic Disease and Its Complications 170 Crohn s Disease 171... 

Preduodenal portal vein (PPV) is a rare congenital anomaly associated with additional various anomalies, including intestinal malrotation, situs anomalies, IVC anomalies, polysplenia, pancreatic anomalies, duodenal atresia, and cardiac anomalies (Tsuda et al. 1991 Gayer et al. 1999). On CT, the preduodenal and prepancreatic localization of the portal vein is demonstrated, as well as any associated anomalies (Fig. 9.5). The diagnosis of a PPV before surgical intervention in the upper abdomen is important to prevent its inadvertent ligation or transection (Tsuda et al. 1991). 

Fig. 9.5. Preduodenal portal vein (arrowhead) is seen crossing laterally to the descending part ofthe duodenum (arrow) in a patient with associated congenital anomalies of situs inversus and interrupted IVC (Reprinted with permission from Gayer et al. 1999)...

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