Abstract
IntroductionA left paraduodenal hernia is a rare congenital malrotational anomaly of the midgut that occurs in the paraduodenal fossa of Landzert to the left of the fourth duodenum. It is responsible for approximately 1% of small bowel obstructions.Case presentationWe report a case of left paraduodenal hernia combined with small bowel obstruction in a 47-year-old Mediterranean woman who had a history of recurrent abdominal pain. An abdominal computed tomography scan showed a saclike mass clustered in the left upper quadrant but failed to yield a clear diagnosis. We describe the surgical anatomy of this disease and the emergency surgical management together with a short review of the literature.ConclusionsEven though a left paraduodenal hernia is rare, it must be suspected in any upper intestinal occlusion. The high morbidity and mortality rate of complicated cases should motivate preventive treatment in case of incidental operative discovery.
Highlights
A left paraduodenal hernia is a rare congenital malrotational anomaly of the midgut that occurs in the paraduodenal fossa of Landzert to the left of the fourth duodenum
Even though a left paraduodenal hernia is rare, it must be suspected in any upper intestinal occlusion
Paraduodenal hernias are the most common form of internal hernias and are responsible of approximately 1% of small bowel obstructions [1]. They were first described in the nineteenth century under various names: left paraduodenal hernia (LPDH), Treitz retroperitoneal hernia, hernia of the fossa of Landzert, mesentericoparietal hernia of Longacre, and hernia into the descending mesocolon of Callander [2]
Summary
Paraduodenal hernias are the most common form of internal hernias and are responsible of approximately 1% of small bowel obstructions [1]. They were first described in the nineteenth century under various names: left paraduodenal hernia (LPDH), Treitz retroperitoneal hernia, hernia of the fossa of Landzert, mesentericoparietal hernia of Longacre, and hernia into the descending mesocolon of Callander [2]. Case presentation A 47-year-old Mediterranean woman presented to our emergency department with abdominal pain and vomiting suggesting an acute small bowel obstruction. Her past medical history was marked by recurrent diffuse abdominal pain several years ago that resolved spontaneously or after taking phloroglucinol.
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