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We present a term infant with the unusual findings of malrotation in combination with both duodenal and pyloric webs of windsock type, thus masquerading as postoperative bowel dysfunction and ultimately requiring three laparotomies. To the best of our knowledge these three findings in combination have not been previously reported. The dilemma of whether to perform a duodenotomy or not during malrotation repair and the importance of instrumenting the intestine from the duodenotomy site in both retrograde and antegrade directions are discussed.

Three laparotomies later: extrinsic duodenal atresia from malrotation complicated by intrinsic duodenal and pyloric windsock webs