Extrinsic duodenal obstruction from anomalous congenital band.

Case Report A nine-day-old male infant was transferred from a local hospital to our institution with persistent bilious vomiting since birth. He had been delivered full term per vaginam to a 28-year-old gravida 5, para 4, and weighed 3280 g. During the pregnancy, maternal ultrasound scan revealed polyhydramnios. At presentation, clinical examination was unremarkable. A plain abdominal radiograph was normal. An upper gastrointestinal (GI) study showed a mild dilatation of the proximal duodenum, a hold-up at the third part of the duodenum, with passage of contrast into the proximal jejunum. The ligament of Treiz was in the normal position (Figures 1A-1D). The patient was kept on conservative management of intravenous fluids and nasogastric tube decompression. He underwent laparotomy, which revealed an ACB arising from the antimesenteric wall of the third and fourth parts of duodenum as far as the ligament of Treiz, and extending across the proximal jejunum to the root of the mesentery (Figure 2). The band which contained tiny vessels was lysed. At follow-up 10 months later, the infant was asymptomatic and thriving.