case_images: PMC11731569_01
case_images: Upper gastrointestinal imaging examination with meglumine diatrizoate (A and B) and abdominal contrast-enhanced CT (C and D). (A) After the oral administration of 50 mL of meglumine diatrizoate for upper gastrointestinal imaging examination, the contrast agent was observed in the first and second portions of the duodenum, with abrupt compression in the third portion of the duodenum and retrograde flow of the contrast medium proximal to the obstruction. The location of duodenal compression is marked with a red arrow, and the duodenum on the oral side of the marked location is dilated. (B) After approximately 10 min, a small amount of contrast agent slowly passed through the horizontal portion of the duodenum. Red arrows indicate the passage of the contrast agent through the site of duodenal compression. (C) In the sagittal plane, the SMV and AA were nearly parallel, and the nearest distance between them was 4.7 mm. (D) Upon reconstruction, the complete horizontal part of the duodenum was showed, and the dilation and narrowing of the duodenum could be clearly observed. In panels C and D, the white arrow indicates the SMV, the red arrow, the AA, and the blue arrow, the duodenal compression site.
case_images: gr1.jpg
case_images: PMC11731569_01_gr1.jpg
case_images: fig1
case_images: Notably, the contrast agent demonstrated an abnormal round-trip flow anterior to the spine at the duodenal level(Fig. 1A), with pooling and gradual passage through this region in strands after prolonged retention(Fig. 1B). SMV was extended, with the SMV anteriorly accompanying the AA. Situated anterior to the spine, the third portion of the duodenum traversed the anterior aspect of the spine at the level of the third lumbar vertebra through a confined passage between the SMV and AA, with the distance between the two vessels measuring 4.7 mm(Fig. 1C). Upon reconstruction, the complete horizontal part of the duodenum was showed, and the dilation and narrowing of the duodenum could be clearly observed(Fig. 1D).