PMC10333570_01
Preoperative imaging studies. (A) Chest radiograph showing the double-bubble sign with situs inversus. (B) Upper gastrointestinal contrast-enhanced imaging revealing duodenal atresia. The distal duodenum was enhanced through the accessory pancreatic duct. (C) Abdominal radiograph showing the double-bubble sign with situs inversus.
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F1
Abdominal radiography revealed a double-bubble sign with situs inversus (Figure 1C).
Laparoscopic findings for case 1. (A) The PDPV is confirmed. (B) The duodenum was obliterated near the pyloric end. (C) Gastrojejunostomy is performed using a 5 mm stapler (white arrow). PDPV, preduodenal portal vein.
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F2
Laparoscopy revealed situs inversus and duodenal atresia with a PDPV (Figures 2A,B). A laparoscopic gastrojejunostomy was performed using a 5 mm stapling instrument (Figure 2C).
PMC10333570_02
Preoperative imaging studies. (A) Chest radiograph showing the double-bubble sign with situs inversus. (B) Upper gastrointestinal contrast-enhanced imaging revealing duodenal atresia. The distal duodenum was enhanced through the accessory pancreatic duct. (C) Abdominal radiograph showing the double-bubble sign with situs inversus.
fped-11-1220393-g001.jpg
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F1
Abdominal radiography revealed a double-bubble sign with situs inversus (Figure 1C).
Laparoscopic findings for case 2. (A,B) A PDPV and duodenal atresia with an annular pancreas were diagnosed. (C) Gastrojejunostomy was performed using a 5 mm stapler (white arrow). PDPV, preduodenal portal vein.
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F3
Laparoscopy revealed situs inversus, annular pancreas, malrotation, and duodenal atresia with a PDPV (Figures 3A,). A laparoscopic gastrojejunostomy was performed using a 5 mm stapling instrument (Figure 3C).
Schema of port placement and anastomosis. (A) A 5 mm balloon port for the laparoscope and three 3 mm trocars for the working port were placed at the umbilicus, right and left flanks, and left upper abdomen, respectively. (B) A laparoscopic gastrojejunostomy was performed about 10 cm from the ligament of Treitz in case 1. (C) Laparoscopic gastrojejunostomy was performed 10 cm from the duodenal atresia site in case 2.
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F4
Three 3 mm trocars were placed on the right flank, left flank, and left upper abdomen (Figure 4A). The anastomosis was performed via the antecolic route and antiperistalsis (Figures 4B,C).