PMC6145535_01
A CT scan without IV contrast showed generalized esophageal wall thickening and mild duodenal (marked by "D") wall thickening (b). The duodenal sweep does not cross the midline (a-c), consistent with a malrotation. There is no obstruction identified. The transverse colon evaluation was limited due to motion blur. The SMV (marked by "V") is anterior and to the right of the SMA (marked by "A"), as would be found normally. EUS performed showed a duodenal mass in the second portion of the duodenum that measured 3-4 cm. CT, computed tomography; EUS, endoscopic ultrasound; SMA, superior mesenteric artery; SMV, superior mesenteric vein.
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He had a computed tomography to further delineate the mass and to assist with operative planning, which showed thickening of the duodenum as well as a partial malrotation at the third and fourth portions of the duodenum such that the ligament of Treitz failed to cross the midline (Fig. 1).