Right paraduodenal hernia: characteristic MDCT findings

Liao, Yen-Hsiu; Lin, Chien‐Heng; Lin, Wei-Che

doi:10.1007/s00261-010-9635-3

Cited by 14 publications

(3 citation statements)

References 12 publications

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“…As a result, a part of, or almost the entire, small bowel is trapped between the ascending mesocolon and the posterior peritoneum, which together form the hernial sac. The true peritoneal cavity communicates with the sac through a small opening in Waldeyer's fossa, a peritoneal fold reported in about 1% of autopsies that is bordered by the third part of the duodenum, the superior mesenteric vessels, and the posterior peritoneum . Depending on the extent of malrotation, an RPH may be associated with the absence of the third and fourth parts of the duodenum, inversion of the superior mesenteric vessels (the vein on the left and the artery on the right), or an incompletely rotated colon .…”

Section: Discussionmentioning

confidence: 99%

Right paraduodenal hernia successfully treated with laparoscopic surgery

Tomino

Itoh

Yoshida

et al. 2015

Asian J Endoscop Surgery

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A 23-year-old Japanese man presented with a history of sudden-onset right abdominal pain accompanied by nausea and vomiting. Contrast-enhanced CT showed a large cluster on the right side of the retroperitoneum, with most of the small bowel incarcerated. The patient was diagnosed with small bowel obstruction caused by a right paraduodenal hernia, and emergency laparoscopic surgery was performed. The large retroperitoneal cluster on the right side contained almost all segments of the small bowel, although the incarcerated bowel showed no evidence of volvulus or ischemia. The bowel was reduced, and the hernia orifice was closed. The patient made good progress and was discharged 7 days after surgery. We herein report an acute case of right paraduodenal hernia with small bowel obstruction that was successfully treated with emergency laparoscopic surgery. With an early preoperative diagnosis, laparoscopic surgery is appropriate for the treatment of right paraduodenal hernia.

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Section: Discussionmentioning

confidence: 99%

Right paraduodenal hernia successfully treated with laparoscopic surgery

Tomino

Itoh

Yoshida

et al. 2015

Asian J Endoscop Surgery

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“…In addition, because the fossa of Waldeyer extends rightward and downward into the ascending mesocolon, the right colic vein is displaced anteriorly by the entrapped intestine (29). In cases of intestinal nonrotation, the superior mesenteric vein exists more left and ventral than usual in relation to the superior mesenteric artery, and the normal third portion of the duodenum is not observed (22,28,29).…”

Section: Right Paraduodenal Herniamentioning

confidence: 99%

“…Portal venous phase scans are considered to be the most important, with (21). Therefore, routine administration of oral contrast material before CT is considered unnecessary (8,21,22). Multidetector CT scanning protocols differed slightly among the cases described in this article because CT images were collected from multiple institutions.…”

Section: Classificationmentioning

confidence: 99%

Internal Hernias in the Era of Multidetector CT: Correlation of Imaging and Surgical Findings

et al. 2016

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Clinical diagnosis of internal hernias is challenging because of their nonspecific signs and symptoms. Many types of internal hernias have been defined: paraduodenal, small bowel mesentery-related, greater omentum-related, lesser sac, transverse mesocolon-related, pericecal, sigmoid mesocolon-related, falciform ligament, pelvic internal, and Roux-en-Y anastomosis-related. An internal hernia is a surgical emergency that can develop into intestinal strangulation and ischemia. Accurate preoperative diagnosis is crucial for appropriate management. Multidetector computed tomography (CT), with its thin-section axial images, high-quality multiplanar reformations, and three-dimensional images, currently plays an essential role in preoperative diagnosis of internal hernias. The diagnostic approach to internal hernias at multidetector CT includes detecting an intestinal closed loop, identifying the hernia orifice, and analyzing abnormal displacement of surrounding structures and key vessels around the hernia orifice and hernia sac. At each step, multidetector CT can depict pathognomonic findings. A saclike appearance suggests an intestinal closed loop in several types of internal hernias. Convergence, engorgement, and twisting of mesenteric vessels in the hernia orifice can be seen clearly at multidetector CT, especially with use of multiplanar reformations. For definitive diagnosis of an internal hernia, analysis of displacement of anatomic landmarks around the hernia orifice is particularly important, and thin-section images provide the required information. Detailed knowledge of the anatomy, etiology, and imaging landmarks of the various hernia types is also necessary. Familiarity with the appearances of internal hernias at multidetector CT allows accurate and specific preoperative diagnosis. (©)RSNA, 2015.

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