A Rare Anomaly of Duodenum: A Case Report
AbstractAnatomical variations of duodenum such as atresia, stenosis, and variations in shape have been described by various authors, but the existence of a gross anomaly in shape and position of midgut segment of the duodenum is rare. Few reported cases of duodenal anomalies date back to early twentieth century. In the wake of advancement of imaging techniques and minimal access surgeries, authors report a case of a rare duodenal anomaly. The reported case assumes significance because of thepossibility of misinterpretation of radiological images which has been discussed while citing such references. The present case reports an anomaly of the position of the midgut segment of the duodenum in an adult female cadaver. It was observed that the lower half of second part of duodenum was coiled like a serpent on the upper pole of right kidney. This part coursed initially upwards running parallel and to the right of the upper half of the second part of the duodenum. The third part coursed downwards and to the left, posterior to head and neck of pancreas, in its course sandwiching the commencement of portal vein.
Dousei T, Yoshikawa K, Hashimoto T, Yamaguchi T, Tominaga H. An adult case of aduodenal anomaly. Surgery Today 1997;27:749-52.
Standring S, Ellis H, Healy JC. Duodenum. In: Gray’s Anatomy -The Anatomical Basis of Clinical Practice. 39th ed. London: Churchill Livingstone, 2005:1163.
Hollinshead WH. Anatomy for Surgeons. In: stomach, duodenum, pancreas and spleen. 2nd ed. New York: Harper and Row Publishers Inc, 1971:407-23.
Saunders JBDM, Lindner HH. Congenital Anomalies of the Duodenum. Ann Surg 1940;112:321-38.
Armstrong GE. Abnormal position of the duodenum. Ann Surg 1910;52:111-5.
Anderson JH. Abnormalities of the duodenum. Br J Surg 1923;10:316-21.
Telfer SV. A case of abnormal disposition of the peritoneum. J Anat Physiol 1915;49:136-9.
Wagstaffe WW. Case of Abnormal Duodenum. J Anat 1924;58:178-9.
Dott NM. Anomalies of intestinal rotations: Their embryology and surgical aspects: With report of five cases Br J Surg 1924;11:251-86.
Nat BS, Mookerji PD. Abnormal Duodenum. Anatomy 1930;64:250-3.
Gravgaard E, Holm-Moller S, Andersen D. Malrotation of the duodenum and duodenal ulcer. Scand J Gastroenterol 1977;12:589-92.
Thommesen P, Olesen M, Christensen L, Funch-Jensen P, Petersen B, Lundorf E, et al. The incidence of severe duodenal anomalies in patients submitted to barium meal examination, in normals, and in different clinical subgroups. Scand J Gastroenterol 1987;22:1175-80.
Thommesen P. The shape of the duodenal loop: radiological, physiological and clinical aspects in patients with x-ray negative dyspepsia. Dan Med Bull 1988;35:537-49.
Zighelboim J, MacCarty RL, Talley NJ. Abnormalities in the shape of the duodenal loop on x-ray. Dig Dis Sci 1995;40:128-33.