Masumoto Kouji, Teshiba Risa, Esumi Genshiro, Nagata Kouji, Nakatsuji Takanori, Nishimoto Yuko, Yamaguchi Sadako, Sumitomo Kenzo, Taguchi Tomoaki
Department of Pediatric Surgery, Reproductive and Developmental Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
World J Gastroenterol. 2009 Aug 21;15(31):3950-3. doi: 10.3748/wjg.15.3950.
A preduodenal portal vein (PDPV) is known to be a rare cause of duodenal stenosis. We treated a 22-year-old male patient with malnutrition as a result of PDPV and a previously performed operation for scoliosis, who showed an improvement in quality of life after being treated with a combination of nutritional support and surgery. The patient with PDPV had been admitted to our department with duodenal stenosis, ranging from the first to third portions. He had suffered from vomiting since 1 year of age, and he developed malnutrition during the last 6-mo period after orthopedic surgery for scoliosis. The stenosis was related to both the PDPV and the previously performed operation for scoliosis. After receiving nutritional support for 6 mo, a gastrojejunostomy with Braun's anastomosis for the first portion and a duodenojejunostomy for the second and third portions were performed. The postoperative course was almost uneventful. Three months later, he was discharged and able to attend university. In patients with widespread duodenal stenosis, there may be a complicated cause, such as PDPV and duodenal stretching induced by previous spinal surgery.
十二指肠前门静脉（PDPV）是十二指肠狭窄的一种罕见病因。我们治疗了一名22岁的男性患者，该患者因PDPV以及先前进行的脊柱侧弯手术而出现营养不良，在接受营养支持和手术联合治疗后生活质量得到改善。患有PDPV的患者因十二指肠狭窄（范围从第一部分到第三部分）入住我科。他自1岁起就一直呕吐，在脊柱侧弯矫形手术后的最后6个月期间出现了营养不良。狭窄与PDPV以及先前进行的脊柱侧弯手术均有关。在接受6个月的营养支持后，对十二指肠第一部分进行了带布朗吻合术的胃空肠吻合术，对第二和第三部分进行了十二指肠空肠吻合术。术后过程基本顺利。三个月后，他出院并能够上大学。在广泛十二指肠狭窄的患者中，可能存在复杂的病因，如PDPV和先前脊柱手术引起的十二指肠牵拉。
