A case report of left paraduodenal hernia with a spontaneous reduction on follow-up: the rare demonstration on computed tomography

Saurabh Maheshwari,Uddandam Rajesh,Saikat Bhattacharjee,Vibhuti Maria,Ajay Khadka

doi:10.1186/s43055-020-00338-4

Saurabh Maheshwari, Uddandam Rajesh + Show 3 more

Open Access

https://doi.org/10.1186/s43055-020-00338-4

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Abstract

BackgroundLeft paraduodenal hernia (PDH) makes for around 40% of all internal hernias. It is due to the prolapse of bowel through fossa of Landzert, an anatomic variant that is found in around 2% of the population. This hernia is presumed to be spontaneously reducible in many patients with recurrent symptoms.Case presentationThe present report shows the case of this condition in a 65-year-old male presenting with recurrent abdominal pain and subacute intestinal obstruction who was unwilling for surgery and was managed conservatively. A follow-up scan after 11 months revealed complete spontaneous resolution of hernia.ConclusionsThis represents only the second demonstration of the oft-mentioned spontaneous reduction of this condition on computed tomography. The radiologists should be aware of this uncommon entity and in the event of clinical suspicion; the imaging should be performed when the patient is symptomatic.

Highlights

Left paraduodenal hernia (PDH) makes for around 40% of all internal hernias
Left-sided PDH, where the bowel loops herniate through fossa of Landzert, makes around 75% of all PDH [2]
There is only one previous case report demonstrating the spontaneous reduction on computed tomography (CT) [4]

Summary

Background

Internal hernias have an overall incidence of around 1% and cause around 4% of all cases of intestinal obstruction [1]. This report shows the case of a 65-year-old male with left-sided PDH who was managed conservatively, and a follow-up scan revealed a complete reduction of the hernia. There was no other abnormality in the abdomen and pelvis except multiple simple renal cysts Based on these findings, the patient was diagnosed as a case of left-sided paraduodenal hernia. The patient was diagnosed as a case of left-sided paraduodenal hernia The patient had three episodes of recurrence of symptoms before a follow-up CECT scan done at 11 months This scan revealed complete resolution of previously seen herniation of bowel loops. He did not provide consent for the same He is on regular follow-up with intermittent recurrence of symptoms which are managed conservatively. This study was in compliance to the latest version of the Helsinki Declaration

Discussion

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Conclusion