Preduoenal portal vein: An unusual presentation in a jaundiced adult

Preduodenal portal vein commonly present in neonate and delayed presentation in adulthood is rarely reported. We presented a case of preduodenal portal vein in a man who presented with features of ascending cholangitis. Physical examination was unremark-able. An ultrasound of the biliary system demonstrated gallbladder stone with dilated left intrahepatic ducts. The right hepatic duct and common bile duct were spared. ERCP revealed a small common bile duct and intrahepatic duct with distortion of the ampulla. CT abdomen shows malrotation of the gut with preduodenal portal vein and abnormality of the intrahepatic inferior vena cava. MRCP showed a normal caliber of biliary tree except for a small abrupt tapering at the common channel. Otherwise the anatomical location of pancreatic duct is normal. We are reporting our unique case and the radiographic images are discussed. The literature of PDPV with other visceral organs anomalies are reviewed.