TWO CASES OF PARADUODENAL HERNIA

Abstract

We experienced two cases of paraduodenal hernia which were found during surgery for other diseases. Case 1 was a 57-year-old man undergoing surgery for carcinoma of the descending colon. During surgery left paraduodenal hernia was found, but no strangulation was observed. Accordingly, the jejunum was repositioned to outside of the hernial sac and left hemicolectomy was performed. Case 2 was a 58-year-old woman undergoing surgery for adenoma of the ascending colon. During surgery right paraduodenal hernia was observed, but there was no finding of strangulation. Therefore, the small intestine was repositioned to outside of the hernial sac and right hemicolectomy was carried out. In both patients, paraduodenal hernia had not been diagnosed preoperatively. On the X-ray films of the abdomen, however, gas-like images were observed at the sites corresponding with the hernial sac. The transillumination of the upper digestive tract conducted at elsewhere before surgery showed images of sacciform accumulation in the small intestine. CT also demonstrated the image of sacciform accumulation in the small intestine. These findings are characteristic of paraduodenal hernia and should be taken into account in the preoperative diagnosis.