Arafa Ahmed, Abdelhafez Abdelhafeez Mohamed, Ragab Ahmed S, Mohamed Abdelhalem Showkat
Pediatric Surgery Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
Pediatric Surgery Department, Faculty of Medicine, Beni Suef University, Beni Suef, Egypt.
BMC Pediatr. 2025 Sep 9;25(1):676. doi: 10.1186/s12887-025-06009-5.
To present a case series of four pediatric patients with PDPV, each with a different clinical presentation and surgical management.
We retrospectively reviewed four cases of PDPV managed at our institution. Two cases were associated with extrahepatic biliary atresia (EHBA) and discovered incidentally during surgery. The other two cases presented with duodenal obstruction but had differing etiologies and management approaches.
Two patients with EHBA underwent successful Kasai portoenterostomy; PDPV was discovered intraoperatively and required no intervention. One patient had duodenal obstruction due to PDPV compressing the duodenum and underwent laparoscopic duodenoduodenostomy. Another patient had duodenal obstruction due to malrotation; a Ladd's procedure was performed. PDPV was noted intraoperatively but was not the obstructing factor.
PDPV can present variably, ranging from an incidental finding to a causative factor in duodenal obstruction. Its recognition is crucial during abdominal surgery to avoid inadvertent injury and to tailor the surgical approach based on associated anomalies.
介绍4例小儿先天性门静脉-十二指肠前位（PDPV）患者的病例系列，每例患者临床表现和手术处理方式各异。
我们回顾性分析了在我院接受治疗的4例PDPV病例。其中2例与肝外胆管闭锁（EHBA）相关，在手术中偶然发现。另外2例表现为十二指肠梗阻，但病因和处理方式不同。
2例EHBA患者成功接受了Kasai肝门肠吻合术；术中发现PDPV，无需干预。1例患者因PDPV压迫十二指肠导致十二指肠梗阻，接受了腹腔镜十二指肠十二指肠吻合术。另1例患者因肠旋转不良导致十二指肠梗阻，实施了Ladd手术。术中发现了PDPV，但它不是梗阻因素。
PDPV的表现多样，从偶然发现到成为十二指肠梗阻的病因。在腹部手术中识别它至关重要，可避免意外损伤，并根据相关异常情况调整手术方式。
