Left Paraduodenal Hernia Presenting with Atypical Symptoms

Abstract

Paraduodenal hernias are a rare congenital malformation, but they are the most common internal hernias. They develop secondary to a failure in midgut rotation, which may lead to small bowel obstruction or other clinical manifestations. The authors recently experienced a case of a left paraduodenal hernia presenting with unusual symptoms of left flank pain and vomiting.

Acute intestinal obstruction secondary to left paraduodenal hernia: a case report

“…Some patients may experience recurrent symptomatic episodes that are often postprandial and relieved in the supine position. [7] Diagnosis of paraduodenal hernia is often difficult due to variable presentation and unremarkable findings during the physical examination. However, paraduodenal hernia should be considered in cases of acute intestinal obstruction in male patients with no prior history of abdominal surgery.…”

“…Preoperative diagnosis of paraduodenal hernia was possible in this case as a result of several published reports describing diagnostic imaging characteristics. [2,7] Surgical treatment of left paraduodenal hernia follows the basic principles of hernia surgery: reduction of the contents, restoration of normal anatomy, and repair of the defect. [7] However, prompt surgical intervention is required for the prevention of strangulation and gangrene in cases with acute intestinal obstruction.…”

Left Paraduodenal Hernia: Case Report

“…Acil durumlarda tanı genelde operasyon esnasında konur. 6 PDH'ler inkarserasyon ve strangülasyon nedeniyle %20-50 hayati riske sahiptir. 9 PDH ile ilgili en kabul edilen teori 1923 yılında Andrews tarafından ortaya atılmıştır.…”

“…6 Defektin onarılamadığı durumlarda orifisi çevre dokulara zarar vermeden genişletmek ilerideki herni rekürrensini önleyebi-lir. 13 PDH'ler ileusun nadir bir nedenidir.…”

“…5 Bulgular ve semptomlar genelde nonspesifiktir. 6 Superior mezenterik arter sol PDH kese ağzının serbest kenarını oluşturur. Tıkanmanın akut döneminde superior mezenterik artere olan basıdan dolayı barsaklarda gangren meydana gelebilir.…”