PMC6323429_01
(a) Endoscopic image, normal duodenum. (b)-(c) Upper gastrointestinal series with small bowel following through with barium contrast. (d) Exploratory laparotomy.
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She then underwent a diagnostic esophagogastroduodenoscopy which revealed a normal duodenum (Figure 1(a)). An upper gastrointestinal series with small bowel follow through using barium contrast showed no evidence of gastric outlet obstruction; however, the duodenal course was abnormal, with the proximal portion looping back on itself in the right abdomen and extending superiorly to the level of the duodenal bulb (Figure 1(b)) before crossing the midline with loops of small bowel in the left upper quadrant (Figure 1(c)). She underwent an exploratory laparotomy which showed proximal loops of jejunum adhered to the right lower quadrant and patulous appearing first and second portions of the duodenum (Figure 1(d)).