Korean J Gastroenterol.  2009 Jun;53(6):369-372. 10.4166/kjg.2009.53.6.369.

A Case of Left Paraduodenal Hernia Combined with Acute Small Bowel Obstruction

• Cho EY
• Choi CS
• Yoo NJ
• Hwang ET
• Lee JY
• Kang DB
• Choi SC

• KMID: 1792754
• DOI: http://doi.org/10.4166/kjg.2009.53.6.369

Abstract

Paraduodenal hernias are rare congenital malrotational anomalies of midgut that arise in the potential spaces and folds of the posterior parietal peritoneum adjacent to the ligament of Treitz and can lead to intestinal obstruction. Also, they have shown several presentation patterns, such as asymptomatic, chronic intermittent abdominal pain, and acute severe abdominal pain. If symptomatic hernias with strangulation are untreated, according to the previous reports, they lead to overall mortality exceeding 50%. We report a case of the left paraduodenal hernia combined with small bowel obstruction from the patient who had no history of surgery before and developed abdominal pain after drinking of alcohol heavily. Abdominal CT scan showed sac-like mass of clustered in the left upper quadrant. The patient underwent the surgery of the bowel reduction and adhesiolysis and got uneventful recovery.

Keyword

Hernia; Intestinal obstruction

MeSH Terms

Abdominal Pain
Diagnosis, Differential
Duodenal Diseases/complications/*diagnosis/pathology
Hernia/complications/*diagnosis/pathology
Humans
Intestinal Obstruction/complications/*diagnosis/pathology
Male
Middle Aged
Tomography, X-Ray Computed

Figure

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  Fig. 1. Abdominal CT findings. (A) The axial image of the CT scan showed sac-like mass of clustered bowel in the left upper quadrant and the expanded prox-imal bowel loop. (B) The coronal image showed the encapsulated bowel loop between stomach and pancreas.

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  Fig. 2. (A, B) Laparoscopic view. It shows hard fibrous band and hernia sac around Treitz's ligament, which was the cause of jejunal obstruction.

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  Fig. 3. Operation finding. It showed manual reduction and division of paraduodenal hernia sac.

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