Prepancreatic postduodenal portal vein.

Dear Editor, I read with great interest the pictorial essay entitled “Cross-sectional imaging of congenital and acquired abnormalities of the portal venous system” by Özbayrak and Tatlı in November-December 2016 issue of Diagnostic and Interventional Radiology (1). The authors are to be congratulated for their effort on giving detailed information about the abnormalities of the portal venous system. Regarding congenital abnormalities of the portal vein, I would like to contribute anomalous preduodenal portal vein and peripancreatic postduodenal portal vein (PPPV) as rare vascular variants. Between these two, PPPV is an extremely unusual developmental abnormality with only a few cases reported in the literature (2, 3). In this circumstance, the abnormally shaped portal vein originates in front of the pancreatic head and runs cranially in close proximity to pancreas and posteriorly to duodenum. The abnormal early division of PPPV may simulate cavernous transformation (Fig). Awareness of these portal vein anomalies are important to prevent misdiagnosis and avoid devastating surgical complications, including portal vein ligation, resection, or intraoperative hemorrhage.