Preduodenal portal vein

Last revised by Henry Knipe on 19 Oct 2023

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

In ~50% of patients, a preduodenal portal vein was found incidentally through laparotomy or imaging for other reasons. If patients have symptoms, they are generally pediatric and present with symptoms of duodenal obstruction 4

The precise etiology is unknown, however, it is thought to occur due to incorrect formation of the fetal vitelline veins 2

A preduodenal portal vein is often part of a heterotaxy syndrome or polysplenia syndrome or associated with 3:

On CT with contrast, the main trunk of the portal vein is seen tracking anterior to the duodenum. 

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

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