“…While present in 3-5% of children with congenital duodenal obstruction, the preduodenal portal vein is almost always an incidental finding and is rarely the cause of obstruction [1,5]. Fewer than two dozen cases of preduodenal portal vein have been reported in the literature where the vein itself has been confidently ascribed as the cause of the obstruction [43,[45][46][47][48][49][50][51][52]. Preduodenal portal vein is rarely an isolated anomaly, and symptomatic children usually present with manifestations of other malformations, including malrotation with Ladd bands, duodenal atresia, biliary atresia and cardiac defects [43,46,47,51].…”