Rare small bowel obstruction: Right paraduodenal hernia. Case report

Abstract

Paraduodenal hernia is a rare pathology but its involvement in bowel obstruction syndrome should be always taken into account during diagnostic process.

Laparoscopic repair of left paraduodenal hernia in an adult: case report and literature review

“…In 1857 Treitz defined an internal hernia as a retroperitoneal protrusion of an abdominal organ through a peritoneal fold and the first classification in right and left was done in 1889 by Jonnesco. 1,15,16 Internal hernias can be either congenital or acquired,such as postoperative after bariateric surgery. 2 Internal hernias are rare with the 0.2-0.9% cases of intestinal obstruction and with 0.5-4.1% cases of intestinal obstruction caused by hernia.…”

“…2,[12][13][14] The symptoms are often misinterpreted as functional gastrointestinal problems such as irritable bowel syndrome or non-ulcer dyspepsia. 15 SBO with strangulation occurs in up to 66% of all patients during their lifetime, with a mortality of 20% or more. PDH should be repaired once diagnosed, due to high risk of obstruction with associated mortality.…”

A Rare Etiology of Intestinal Obstruction: Paraduodenal Hernia

“…One theory suggests mechanical forces of undulating intra-abdominal pressure to lead to herniation in places where the peritoneum is yet incompletely fused. Andrews first described the currently accepted mechanism of formation as a type of malrotation [5]. During the period between the fifth and 11th weeks of gestation, there is a midgut rotation and the fusion of mesentery with the posterior abdominal structures from the ligament of Treitz to the right iliac fossa [3,5,7].…”

“…Andrews first described the currently accepted mechanism of formation as a type of malrotation [5]. During the period between the fifth and 11th weeks of gestation, there is a midgut rotation and the fusion of mesentery with the posterior abdominal structures from the ligament of Treitz to the right iliac fossa [3,5,7]. The space into which the bowel herniates is called Landzert's fossa, and is found behind the fourth part of the duodenum.…”

“…There are two types of congenital paraduodenal hernia: leftsided, which is more common (75%), and right-sided, which is very rare (25%) [4]. There is a sex predilection with a male to female ratio of 3:1 [2,5]. The reported lifetime risk of obstruction and bowel strangulation is around 50% with a mortality of 20% and higher [4,6].…”