Megaduodenum is a rare anomaly in adults. It is usually primary or may be secondary to Chagas disease or systemic sclerosis. This rare problem can be managed by many surgical techniques. We present a case of megaduodenum secondary to a combination of an internal hernia with kinking at the duodenojejunal flexure and chronic superior mesenteric artery (SMA) syndrome which was managed successfully with a side to side Roux-en-Y duodenojejunostomy.
