PMC6319690_01
A magnetic resonance imaging/magnetic resonance cholangiopancreatography showing the third portion of the duodenum not crossing to the left of the SMA and SMV. The entire colon was to the left of the SMA and SMV. Thick arrow, third portion of duodenum; thin arrow, colon. SMA, superior mesenteric artery; SMV, superior mesenteric vein.
fig-1.jpg
PMC6319690_01_fig-1.jpg
f1
Also, the SMA lies to the right of the SMV consistent with gastrointestinal malrotation (Fig. 1).
PMC6319690_02
An illustration showing a classic gastrointestinal malrotation, with the entire colon on the left side of the abdomen. The location of malignant involvement from Cases 1 (cholangiocarcinoma) and 2 (pancreatic adenocarcinoma) is delineated.
fig-2.jpg
PMC6319690_02_fig-2.jpg
f2
The scan also showed that the patient's entire colon was on the left side of the abdomen and the small bowel to the right (Fig. 2).
PMC6319690_03
An illustration showing a reversed rotation of the gastrointestinal tract. The SMA lies ventral to the transverse colon. A pancreatic head mass is seen.
fig-3.jpg
PMC6319690_03_fig-3.jpg
f3
Interestingly, the CT scan also showed the colon to be in a dorsal position in relation to the SMA (Fig. 3).