Duodenum inversum: A report and review of the literature

Medical Management of Duodenum Inversum Presenting With Partial Proximal Intestinal Obstruction in a Pediatric Patient

“…Duodenal inversum is a rare anomaly whereby the duodenum courses superiorly and then posteriorly prior to crossing midline above the pancreas head (3, 5). The etiology is unknown but may involve retained dorsal mesentery with a mobile duodenum (1, 3).…”

“…To date, we are aware of two pediatric cases of duodenum inversum published (5, 6), one in a 16-year-old girl with nausea, vomiting, pain, and weight loss mimicking SMA syndrome that did not improve with NJ feedings distal to the obstruction and weight gain, and the other in a 1-month-old boy with Trisomy 21 found during evaluation for reflux. Both underwent surgical exploration with partial Ladd’s procedure and recovered without sequelae.…”

“…Duodenum inversum has been reported in adults (1–4) with only two published reports in children (5, 6). Associated conditions include malrotation, incomplete rotation, annular pancreas, and pancreas divisum (2, 4, 5).…”

“…Management in symptomatic patients varies, with medical management remaining the first line (3–5). In the two published pediatric cases, surgical exploration was indicated (5, 6).…”

Duodenum Inversum: Findings from an upper gastrointestinal series

“…There was no evidence predispose patients to diseases such as cholecystitis, pancreatitis and peptic ulcers. [1][2][3][4][5][6] These symptoms and comorbidities are thought to be due to stasis in the duodenum. 6 Clinicians must therefore be aware of possible comorbidities in patients with duodenum inversum.…”