Malrotation causing duodenal chronic obstruction in an adult

Figure 1 Barium image from upper gastrointestinal series reveals duodenal obstruction, demonstrating high-grade stenosis of the fourth portion of the duodenum and extreme dilation of proximal duodenum (arrow).

Figure 2 CT scan shows duodenum does not cross behind the superior mesenteric artery and the superior mesenteric vein, and extreme dilation of proximal duodenum (arrow).

Figure 3 One band running from the anti-mesenteric wall of proximal jejunum to cecum has been lysed (arrows) and no Treitz’s ligament is found.