Congenital duodenal diaphragm in an adult masquerading as superior mesenteric artery syndrome.

Persistent congenital diaphragm in the second part of the duodenum may rarely present in adults with features of upper gastro-intestinal obstruction. This possibility is often not considered in adults due to delayed onset of symptoms. One such case is reported in a middle aged male who was diagnosed preoperatively with superior mesenteric artery syndrome. However, on exploration, the duodenal diaphragm was found to be the cause of intestinal obstruction that was managed successfully. This rare clinical entity should be kept as a possibility while dealing with cases of duodenal obstruction in adults so as to avoid missed diagnosis and mismanagement.