PMC5133654_01
(A) Radiography of gastrointestinal transit contrasted with abrupt narrowing of the third portion of the duodenum, associated with gastroduodenal dilatation. (B) EBnteroscopy with duodenal extrinsic pulsatile compression (third portion).
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Radiological intestinal transit was performed showing dilatation of the stomach and duodenum and abrupt change in the third portion of the duodenum caliber (Fig. 1A). The transposition of the thinning area was possible with caution (Fig. 1B).
Abdominal angiotomography: sagittal plane showing angle and distance between superior mesenteric artery and aorta; Axial section showing gastric and duodenal dilatation.
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Ports placements.
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A 10 mm port is placed 3 cm below and 3 cm to the left of the patient's umbilicus for the camera. (Fig. 3).
Final aspect of the operation: duodenojejunostomy is performed without division of the 4th portion of the duodenum.
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The final aspect of the operation is demonstrated in Fig. 4.
Postoperative gastrointestinal transit: Free passage of contrast through the anastomosis with significant reduction in gastroduodenal dilatation.
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He was discharged after five days with pureed diet, intestinal transit restored and also partial recovery of weight loss (Fig. 5).