case_images: PMC10387769_01
case_images: Upper gastrointestinal study revealing a dilated duodenum with contrast refluxing back into the stomach (a) and beaking of contrast in the third portion of the duodenum (b).
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case_images: However, the duodenum appeared distended with contrast refluxing back into the stomach (Figure 1a). There was also delay of contrast transit with notable beaking in the third portion of the duodenum (Figure 1b).
case_images: Pre-dilation image of the first duodenal web found in the proximal fourth portion of the duodenum (a) followed by post-dilation (b).
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case_images: The endoscope was easily advanced until the proximal aspect of the fourth portion of the duodenum, where an area of luminal narrowing that measured approximately 1 cm in diameter was found, suggestive of a duodenal web (Figure 2a). Each increment was held for approximately 30 seconds (Figure 2b).
case_images: Pre- (a) and post-dilation (b) images of the second duodenal web found in the distal fourth portion of the duodenum.
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case_images: It measured approximately 5 mm in diameter (Figure 3a). This area of stenosis was dilated serially 10 times, from 6 mm (18-Fr) to 15 mm (45-Fr; Figure 3b).