Preduodenal Portal Vein With Midgut Non-rotation Causing Duodenal Obstruction in a Neonate: A Case Report.

Preduodenal portal vein (PDPV) is a rare congenital vascular anomaly that may cause duodenal obstruction, either in isolation or in association with other gastrointestinal malformations such as intestinal malrotation. We report a neonate who presented on the seventh day of life with bilious vomiting. Imaging studies suggested proximal duodenal obstruction due to extrinsic compression, with findings consistent with a preduodenal portal vein and associated midgut non-rotation. The diagnosis was confirmed intraoperatively, and the infant was successfully managed with duodenoduodenostomy and Ladd's procedure. Although uncommon, PDPV should be considered in neonates presenting with bilious vomiting and proximal intestinal obstruction. Early recognition is essential for guiding appropriate surgical planning and preventing potentially catastrophic intraoperative vascular injury.