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July 1994

Surgical Implications of Preduodenal Portal Vein in the AdultCase Report and Review of the Literature

Author Affiliations

From the Departments of Surgery (Drs Ishizaki and Okuyama) and Pathology (Dr Tanaka), Tokyo (Japan) Metropolitan Hiroo General Hospital.

Arch Surg. 1994;129(7):773-775. doi:10.1001/archsurg.1994.01420310105020

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Occasionally, a preduodenal portal vein (PDPV)is found in pediatric patients with intestinal obstruction due to duodenal compression.1 In adults, it is often symptomless and is an exceptionally rare condition. It is of surgical importance, however, because the vein lies in the most superficial position ventral to the common bile duct and is easily damaged during operations involving the biliary tract and duodenum. We recently treated a patient with PDPV, which stimulated a review of the disease process, including diagnosis, association with other anomalies, and surgical treatment.

REPORT OF A CASE  A 73-year-old woman was admitted to our hospital for treatment of epigastric pain of 3 months' duration. Her medical history revealed cholecystostomy for acute cholecystitis and gastrojejunostomy for asymptomatic stenosis of the second portion of the duodenum at age 32 years and cholecystectomy at age 42 years. A barium study of the upper gastrointestinal tract showed partial obstruction in

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