Small Paraduodenal Hernias

Clinical spectrum of internal hernia: A surgical emergency

“…The reported mortality rate of internal hernia ranges from 38% to 73%. 5,18,23,29,33,36,37 The overall mortality rate in our series was 20%, and all deaths were caused by enteral bacteria sepsis, predominantly Pseudomonas aeruginosa. Thus, we recommend that board-spectrum anti-enteral bacteria antibiotics, ideally an anti-pseudomonas regimen, should be given to geriatric patients with underlying disease.…”

“…It is generally accepted that a time-consuming diagnostic workup before surgery may endanger the life of an acutely ill patient. 6,23,30,33 Some investigators advocate abdominal CT scanning as an appropriate diagnostic technique for such patients. 1,7,17,22,26,27,34 This is because abdominal CT shows the hernia sac and its anatomic relationship to the surrounding organs and vasculature.…”

Left Paraduodenal Hernia: An Uncommon Cause of Acute Abdomen

“…Exploratory laparoscopy plays an important role in resolving an uncertain diagnosis, with an accuracy of >90%; accuracy is 77% for CT 10,13 . The overall mortality rate may exceed 50% in cases of strangulated or ischemic bowel, even after appropriate and emergent surgery.…”

Peritoneal encapsulation, left paraduodenal hernia with retroperitonealization of inferior mesenteric vein leading to triple obstruction

“…The excision of membrane in peritoneal encapsulation is recommended even if this condition is diagnosed incidentally. All paraduodenal hernias must be repaired, including those that are asymptomatic [15]. Release of adhesions in congenital bands and the retroperitonealization of vessel leading to obstruction is recommended.…”