Case Of Left Paraduodenal Hernia Research Articles

PARADUODENAL HERNIA: A HIDDEN CULPRIT

Paraduodenal hernia is a congenital anomaly of developmental defects which occurs due to malrotation of gut in 12th week of embryonic life. This current study represents a case of left paraduodenal hernia with radiological imaging and intra-operative ndings. A 37 years old male presented in surgery OPD, RIMS, Ranchi with complains of recurrent abdominal pain on left side of abdomen since 2 months. CT Scan whole abdomen and pelvis was suggestive of left paraduodenal hernia so patient underwent pre-anaesthetic check up and exploratory laparotomy with hernia repair was done.

An unusual case of left para-duodenal hernia as a cause of recurrent intestinal obstruction-managed with laparoscopic approach

Left para-duodenal hernia (PDH) makes for around 40% of all internal hernias. It is due to the prolapse of the bowel through the 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. The present report shows the case of this condition in a 27-year-old female presenting with recurrent abdominal pain and subacute intestinal obstruction who was managed conservatively initially. She has been operated on with a laparoscopic approach. A proper diagnosis with an immediate surgical intervention is necessary for achieving the patient’s cure and preventing complications in the future. The laparoscopic approach is usually suitable for patients with or without small bowel obstruction and hemodynamically stable.

MANAGEMENT OF LEFT PARADUODENAL HERNIA - A CASE REPORT

Paraduodenal hernias are rare type of internal hernias also known as Treitz hernia or Mesocolic hernia that occur due to congenital anomaly in rotation of the midgut. The anomaly is either malrotation of midgut or failure of mesentery of ascending colon to fuse with parietal peritoneum. The presenting symptoms can range from mild abdomen pain to small bowel obstruction and gangrene. The hernias can be left or right sided depending upon their relationship with the mesenteric vessels of small bowel. Internal hernias, including paraduodenal hernia (the most common), periceacal, foramen of Winslow and inter sigmoid hernias, account for approximately 0.5 to 5.8% of all cases of intestinal obstruction and are associated with high mortality rate. We present a case of left paraduodenal hernia occurring in 40yr old male patient who presented with complaints of mass and pain in left side of abdomen for 1 week. CT imaging was done which showed clusters of dilated bowel segments with displaced mesenteric vessels at hernial orice. After evaluation diagnosed as left paraduodenal hernia and through laparoscopy bowel loops decompressed from the fossa of Landzert and hernial sac repair done. Post operative period was uneventful and was discharged after 3 days. Paraduodenal hernias are rare causes of small bowel obstruction which can be difcult to diagnose clinically and require cross sectional imaging for diagnosis. These hernias occur due to congenital anomaly of malrotation of the small bowel and fusion of mesentery. Surgical correction is done electively or on emergent basis with open or laparoscopic technique depending upon the clinical scenario and availability of laparoscopy

Left paraduodenal hernia treated by single-incision laparoscopic surgery: a case report

BackgroundParaduodenal hernia is a rare internal hernia which accounts for only 1% of all intestinal hernias. There have been limited reported cases of paraduodenal hernia treated by laparoscopic surgery. We report a case of left paraduodenal hernia that was successfully treated by single-incision laparoscopic surgery (SILS).Case presentationA 17-year-old woman presented with left upper abdominal pain. An abdominal enhanced multi-detector computed tomography demonstrated encapsulated cluster of small bowel loops in the left upper quadrant which passed through the dorsal side of the inferior mesenteric vein, and showed that blood flow of the prolapsed small bowel was preserved. We preoperatively diagnosed left paraduodenal hernia without ischemia or necrosis. We performed elective SILS because she was a young actress training school student and cosmetic benefit was thought to be important. We pulled out the protruded small bowel and closed a defect with a running suture by SILS. The patient was discharged 3 days after the surgery with no complications.ConclusionsWe reported the case of left paraduodenal hernia successfully diagnosed and treated by SILS.

Laparoscopic repair of left paraduodenal hernia in an adult: case report and literature review

An internal hernia is a protrusion of bowel through a normal or abnormal orifice in the peritoneum or mesentery and the resulting hernia remains intraperitoneal. The para-duodenal type is the most common type of congenital internal hernias. We reported a case of left paraduodenal hernia, who presented with recurrent attacks of severe abdominal pain and occasional vomiting. The case was diagnosed as a left huge paraduodenal hernia, and prepared for a laparoscopic repair after which he made uneventful recovery and remained free of symptoms when he was seen for follow up in surgery outpatient clinic.

A Case of Left Paraduodenal Hernia That Required Intestinal Resection Despite Immediate Diagnosis after the Onset

A Case of Left Paraduodenal Hernia That Required Intestinal Resection Despite Immediate Diagnosis after the Onset

Laparoscopic management of left paraduodenal hernia. Case report and review of literature

We report a rare case of left paraduodenal hernia in patient with symptoms of abdominal subobstruction treated successful with laparoscopic management in urgent situation that have reduced the length of stay and postoperative pain. Internal hernia is only 1% of the causes of abdominal obstruction and the left paraduodenal hernia about 50% of them; it is a congenital defect that derive from malrotation and abnormal mesenteric adhesion. The modern imaging techniques help for the correct diagnosis despite difficult identification of the pathology for the various clinical presentation. The treatment of choice is the surgical intervention; the laparoscopic approach is rarely described in literature but it can reduce the morbidity, postoperative pain and the length of hospital stay.

Intestinal obstruction due to a left paraduodenal hernia: a case report

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.

MDCTにて術前診断し整復術を行った左傍十二指腸ヘルニアの1例

52歳，男性．主訴は腹部膨満感．近医でイレウスを疑われ，当院紹介となった．腹部CT検査で左傍十二指腸ヘルニアと診断し，緊急手術を施行した．腹腔鏡下に整復を試みたが，脱出腸管が多量で拡張も強かったため，開腹操作に移行した．脱出腸管を整復後，ヘルニア門を閉鎖し手術を終了した．術後，一過性の腸管狭窄を認めたが，保存的に軽快した．術後25日目より食事を開始し退院となった．過去の傍十二指腸ヘルニア報告例を解析した結果，画像診断の発達に従い1990年代には22％であった術前正診率が2000年以降69％と向上を認めた．また，左傍十二指腸ヘルニアでは待機的に腹腔鏡下手術を選択する症例が多くみられたのに対し，右傍十二指腸ヘルニアでは緊急開腹手術が多数を占めていた．しかし，両群共に腸管壊死による腸管切除を施行した症例は少数であるため，本ヘルニアに対しては腹腔鏡下整復術を第1選択にできる可能性が示唆された．

Acute intestinal obstruction secondary to left paraduodenal hernia: a case report

Paraduodenal hernia, the most common type of internal herniation, is rare in the etiology of intestinal obstruction. Delayed diagnosis and surgical intervention may result in significant morbidity and mortality risk. This report presents a case of left paraduodenal hernia resulting in acute intestinal obstruction. A 43-year old male patient was admitted with a diagnosis of acute intestinal obstruction. A left paraduodenal hernia was identified by computed tomography findings of an encapsulated cluster of dilated small bowel loops occupying the left upper quadrant between the stomach and pancreas, and the presence of an engorged and displaced vascular pedicle at the orifice of the hernia. Upon further investigation, the dilated proximal jejunal segments were found in the left paraduodenal fossa, enclosed in a hernia sac. After reducing the intestinal segments to the abdominal cavity, the orifice of the hernia sac was closed by suturing to the retroperitoneum. Paraduodenal hernia should be considered as a possible etiology in cases of acute intestinal obstruction with unremarkable presentations. Physicians should be familiar with the demonstrative imaging findings of computed tomography of a paraduodenal hernia. Early surgical intervention is critical to prevent the significant morbidity and mortality associated with this condition.

Paraduodenal Hernia: A Rare Cause Of Intestinal Obstruction. Case Report And Review Of The Literature.

Paraduodenal hernia is an uncommon cause of intestinal obstruction. However it happens to be one of the common forms of internal herniation. The number of these cases reported in literature is sparse making it a rare form of hernia necessitating detailed study. Understanding the anatomical features of the paraduodenal region in such patients is pivotal in the safe surgical management. Both open and laparoscopic methods can be used. A case of left paraduodenal hernia is reported along with a review of literature.

Left paraduodenal hernia causing small bowel obstruction in an adolescent patient

Internal hernias are an uncommon cause of bowel obstruction, accounting for less than 1% of cases. Paraduodenal hernias, the most common type of internal hernias, are believed to be congenital in origin. They can be asymptomatic, cause chronic abdominal pain, or present with acute intestinal obstruction with strangulation and ischemia. We describe a case of left paraduodenal hernia found in a patient who presented with acute intestinal obstruction.

A Case of Left Paraduodenal Hernia Combined with Acute Small Bowel Obstruction

Paraduodenal hernias are rare congenital malrotational anomalies of midgut that arise in the potential spaces and folds of the posterior parietal peritoneum adjacent to the ligament of Treitz and can lead to intestinal obstruction. Also, they have shown several presentation patterns, such as asymptomatic, chronic intermittent abdominal pain, and acute severe abdominal pain. If symptomatic hernias with strangulation are untreated, according to the previous reports, they lead to overall mortality exceeding 50%. We report a case of the left paraduodenal hernia combined with small bowel obstruction from the patient who had no history of surgery before and developed abdominal pain after drinking of alcohol heavily. Abdominal CT scan showed sac-like mass of clustered in the left upper quadrant. The patient underwent the surgery of the bowel reduction and adhesiolysis and got uneventful recovery.

Left-Sided Paraduodenal Hernia: Report of a Case

Paraduodenal hernias are rare congenital malformations consisting of incomplete rotation of the midgut, which may lead to intestinal obstruction or simply be detected as an incidental finding at autopsy or laparotomy. We report a case of left paraduodenal hernia diagnosed preoperatively by computed tomography and operated on in an emergency setting for signs of peritoneal irritation. A misdiagnosis had been made when the patient suffered his first attack 6 months earlier and he had been treated for familial Mediterranean fever. We reduced the small bowel loops from the left paraduodenal hernia sac with ligation and transection of the inferior mesenteric vessels. The patient was discharged from hospital on postoperative day 4 after an uneventful recovery.