PMC2734930_01
Abdominal X-ray demonstrating abrupt cut off sign at the 3rd portion of duodenum. Dilated stomach and proximal duodenum. Black arrow shows the cut-off sign.
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fig1
Her work-up included plain abdominal films, which demonstrated air in a dilated stomach and duodenum with an abrupt vertical cut off and no evidence of air in the small intestine distal to the 3rd portion of the duodenum (Figure 1).
Upper GI demonstrates obstruction at the 3rd portion of the duodenum. Arrow indicates the cut-off sign.
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fig2
Upper Gastrointestinal series obtained subsequently revealed contrast in the dilated duodenum with an abrupt cut off at the level of the superior mesenteric artery pedicle in a supine position (Figure 2).
Upper GI shows the relief of obstruction by contrast moving distally, once the patient was placed in prone position.
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fig3
Obstruction was relieved once patient was placed in the prone position (Figure 3).