Malrotation of Small Bowel—Diagnostic Computed Tomography (CT) Signs and Intraoperative Findings

Abstract

Right paraduodenal hernia usually occurs in setting of nonrotated small bowel, when small bowel herniates through Waldeyer's fossa (a defect in the first part of jejunal mesentery). It lies behind the superior mesenteric artery and inferior to the transverse colon or third portion of duodenum. We studied two cases of right paraduodenal hernia, an incomplete rotation, and nonrotation of small bowel, respectively, and describe CT abdomen signs, which can give a preoperative diagnosis.

Right para‐duodenal hernia presenting as an abdominal mass with small bowel obstruction

“…The diagnosis is supported by a contrast‐enhanced CT scan and calls for a high degree of clinical suspicion 6 . The multiple and vague symptoms often lead to the diagnosis of non‐specific abdominal pain and the patient is mistreated for a long time till complications set in.…”

“…The diagnosis is supported by a contrast-enhanced CT scan and calls for a high degree of clinical suspicion. 6 The multiple and vague symptoms often lead to the diagnosis of non-specific abdominal pain and the patient is mistreated for a long time till complications set in. If the patient is asymptomatic, treatment should begin as soon as feasible after diagnosis; if the patient has complications, treatment should begin simultaneously.…”

Identification and Repair of Left-Sided Paraduodenal Hernia Using Both Laparoscopic and Robotic Techniques

“…Computed tomography (CT) is the gold standard for diagnosis for PDH [12] but only correctly identifies pathology in 43% of cases [13]. PDH will appear on CT as a cluster of dilated bowel segments, variably with an intestinal closed loop and associated engorged and displaced mesenteric vessels around the hernia orifice and sac [14].…”