Abstract
Many cases of preduodenal portal vein (PDPV) in an association with biliary atresia have been reported so far, but reports on PDPV in adults are rarely seen in the literature. This paper describes a recent experience of an adult case, with an analysis of 12 such cases in the Japanese literature in terms of the onset of the disease and treatment. A 20-year-old woman was admitted to the hospital because of vomiting. Upon operation malrotation of the intestine with PDPV was detected. Ladd's operation and side-to-side anastomosis of the duodenum were carried out. Postoperative course was uneventful except for several episodes of vomiting, which sometimes developed for about one year after the operation. PDPV can cause passage disturbance due to a change in bowel movement, increase in portal blood flow, and visceroptosis. Considering of the onset of the disease, Hashimoto's theory is most convincing, however, it is hard to explain the etiology modistically. When we encounter a patient whose duodenum permits to pass through in some degree, operative procedures might have to include bypass operation and cut off of the original passage. We should have knowledge of PDPV in treating adults surgically in terms of preventing portal injury and lymph node dissection in an association with cancer.
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