Paraduodenal Hernia Research Articles

Laparoscopic treatment of pediatric paraduodenal hernia in Saudi Arabia

Paraduodenal hernia (PDH) is considered the most common type of internal hernia. It accounts for 50% of the internal hernias , which occurs due to failure of the parietal peritoneum to fuse with part of the dorsal mesentery, causing a fossa in the mesocolon . PDH is a rare cause of intestinal obstruction with an unknown incidence in the pediatric population. We present a case of a seven-year-old female patient who presented with non-specific abdominal pain and progressive bilious vomiting for three days. The preoperative diagnosis of the left preduodenal hernia was achieved based on CT findings. The patient underwent laparoscopic repair using a conventional approach. Diagnosis of PDH in pediatric patients requires a high index of suspicion due to the broad spectrum of clinical presentation. Laparoscopic treatment seems to be an efficient and highly effective approach in uncomplicated PDH, resulting in a short length of stay and a fast return to the regular diet.

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.

“PRIMARY INTERNAL HERNIA IN ADULT: A RARE CASE OF ACUTE ABDOMEN”.

Internal hernia is a protrusion of the viscus or part of the viscus through a peritoneal or mesenteric aperture. It can be due to birth defects, trauma, surgical intervention, inammatory conditions, and raised intra-abdominal pressure. The most common internal hernia is paraduodenal hernia, followed by paracecal hernia. In paediatric age groups, internal hernias are found to be more prevalent as compared to adults. Hence, primary internal hernia is the rarest nding in adults. Clinical diagnosis is next to impossible as it may present either with an acute abdomen or with clinical signs of intestinal obstruction. Computed tomography guides us towards making the diagnosis.Here, we present a case of a 20-year old lady with an acute abdomen and who was getting treatment in the line of renal calculi. Computed tomography helped in the planning of surgery. Intraoperatively clumped ileal loops in the right iliac fossa enclosed within a hernial sac lying around the caecum are found, and further exploration reveals that the patient does not have an omentum.

Para-Duodenal Hernia Unusual Presentation of Abdominal Obstruction: A Case Report

A para-duodenal hernia is a type of internal hernia, an atypical congenital anomaly. It presents as abdominal obstruction with adverse manifestations such as strangulation and infraction. Its symptoms can be ambiguous and variable, making them challenging to detect and diagnose. However, prompt intervention is required to avoid further complications. Here, we present the course and management of a 31-year-old male who contributed to our emergency department with symptoms of intestinal obstruction with an unusual C.T. scan and intra-operative findings

Para-duodenal hernia: a rare case report

A para-duodenal hernia (PDH) is a rare type of internal hernia, which results from anomalous rotation and reduction of the midgut loop in the embryo. Diagnosing para-duodenal hernias can be difficult due to the wide range of symptoms that can occur. Preoperative computed tomography of the abdomen facilitates diagnosis and timely surgical intervention, which can be performed openly or laparoscopically. We here report the case of a 22-year-young male patient with a left para-duodenal hernia. He arrived in the emergency with generalized intermittent crampy abdominal pain, associated with nausea and obstipation. An abdominal computed tomography (CT) revealed that he had a left PDH, which was effectively treated with open surgical repair. Clinical presentation of para-duodenal hernia ranges from asymptomatic to manifest. The greatest difficulty regarding the management of para-duodenal hernias lies in their diagnosis. Many studies have shown that the best option for diagnosis is computed tomography (CT). Open and laparoscopic techniques are used in the treatment of para-duodenal hernias with similar results. We report our experience in the management of left para-duodenal hernia. The case of a 22-year-old male patient with LPDH with non-specific symptomatology was presented. CT scan is the best diagnostic option for this condition. The open surgical approach was used with great success.

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

Concomitant ileocecal intussusception due to cecal lipoma and paraduodenal hernia

We present a healthy adolescent male with no past surgical history who presented with acute onset abdominal pain. Cross-sectional imaging was concerning for possible ileocecal intussusception, and repeat imaging demonstrated an internal hernia. The patient was taken to the operating room for exploration. He was discovered to have an ileocecal intussusception with a large cecal mass, as well as a left paraduodenal hernia. Closure of the mesenteric defect and ileocecectomy with primary anastomosis were performed. Pathology of the mass was consistent with colonic lipoma. Postoperatively, he had slow return of bowel function, but his recovery was otherwise uncomplicated. This case reports a rare presentation of concomitant ileocecal intussusception due to a cecal lipoma and congenital internal hernia. Intussusception in the pediatric population is typically idiopathic, and intussusception with a pathologic lead point is far more common in adults. Gastrointestinal lipomas are also uncommon in pediatric patients, and when discovered are generally small and asymptomatic. Internal hernias most commonly are due to acquired mesenteric defects or adhesive disease, though may present congenitally as seen in this patient. This case is unique because of the simultaneous occurrence of two separate surgical problems, both with atypical etiologies based on patient history and demographics.

A Left Paraduodenal Hernia: an “Incidental Finding” in a Virgin Abdomen with Small Bowel Obstruction

BackgroundA left paraduodenal hernia is a rare clinical condition, resulting from embryological abnormalities or anomalies of the peritoneal attachments. Preoperative diagnosis is difficult because of its nonspecific clinical manifestations. Presentation of a CaseA 42-year-old man, with negative surgical history, presented to the emergency department with complaints of severe acute epigastric pain and vomiting of 12 h duration. The patient did not report any episodes of abdominal pain in his history. Computed tomography imaging was suggestive for a closed-loop obstruction. An emergency laparoscopy was performed, revealing a pathologically dilated tangle of jejunal loops and an incidental finding of a left paraduodenal hernia, the latter containing small bowel loops with normal caliber. The small bowel loops were reduced, and the hernia orifice was closed via non-absorbable sutures to restore normal anatomy. The pathologically dilated small bowel segment with serosal scar tissue, probably developed secondary to a previous episode of incarceration, was resected. ResultsA high level of clinical suspicion for a left paraduodenal hernia is advocated in patients with a virgin abdomen, presenting with recurrent vague abdominal pain or acute symptoms of small bowel obstruction. Usually, a left paraduodenal hernia is an incidental finding on computed tomography imaging or during diagnostic laparoscopy. Surgical repair is the mainstay therapy, even in asymptomatic cases, to prevent future small bowel incarceration which develops in almost half of the cases. The laparoscopic approach is feasible and safe, also in an emergency setting. ConclusionsBy presenting this case, we assume to raise awareness as many clinicians are unfamiliar with this rare condition. Clinical suspicion and detailed knowledge of the etiology, anatomy, and vascular landmarks allow surgeons to accurately manage a left paraduodenal hernia.

Left Para duodenal Hernia: Case Report of Rare Cause of Small Bowel Obstruction

Para duodenal hernia [PDH], a rare congenital anomaly, is a type of internal hernia which occurs due to a defect in the reduction and rotation of the midgut. We present the case of a 32-year-old female patient presented with a seven-day history of generalized intermittent colicky abdominal pain accompanied by multiple episodes of bilious vomiting. She was otherwise healthy and had no history of previous abdominal operations. Computed tomography scan of the abdomen demonstrated sac-like clustered small bowel loops noted in the left upper quadrant, in the anterior para-renal space, consistent with the diagnosis of left Para duodenal hernia. Exploratory Laparotomy for the repair of the hernia was planned. The jejunal loops had herniated through the fossa of Waldeyer. Reduction of hernia contents and excision of the hernia sac was carried out. The patient tolerated the procedure without complications, and she was asymptomatic in the follow-up visit. This case sheds light on the importance of considering the diagnosis of left Para duodenal hernia in patients with recurrent abdominal pain, particularly among those who have not undergone abdominal surgery previously.

Right Paraduodenal Hernia Causing Small Bowel Obstruction in an Adult with Down Syndrome: A Rare Case Report

Out of all internal hernias, Paraduodenal Hernia (PDH) is the variety but in PDH right sided one is not that common. In down syndrome, morgagni hernias are often seen as compared to right PDHs. This is a known case of down syndrome presented with chief complaints of abdominal pain, nausea, vomiting and abdominal distension since 2 days. Patient was surgically managed for the right PDH and later re-explored for adhesive intestinal obstruction on postoperative day 12 and later presented with small bowel obstruction symptoms due to adhesions and hence, relaprotomy for postoperative adhesive obstruction was performed. Right PDH is a rare entity encountered in down syndrome which makes it even rare.

Intestinal Obstruction and Bowel Ischemia due to a Rare Left Paraduodenal Hernia: Case Report

Bowel obstruction is one of the most common problems found in outpatient departments (OPDs) and emergency rooms. The challenge for surgeons is to be suspicious and recognizing rare disease that could cause bowel obstruction, such as paraduodenal hernia, without delaying the management as the risk of complications increase. This case study presents a patient with bowel obstruction secondary to a paraduodenal hernia.

Case Report: Right paraduodenal hernia – a unique case of rare internal hernia presenting as acute small bowel obstruction

Paraduodenal hernia, a rare internal hernia, is an uncommon cause of small bowel obstruction. We present a case report of a 45-year-old male presenting to the emergency department with complaints suggestive of small bowel obstruction. Abdominal plain X-ray was also suggestive of small bowel obstruction. Emergency laparotomy showed intraoperative findings of right sided paraduodenal hernia with dilated small bowel. Postoperative hospital stay was uneventful and the patient was doing well during 24 months of follow up with no active complaints. Paraduodenal hernia should be considered as part of the differential diagnosis of small bowel obstruction in patients who have repeated attacks and no prior history of abdominal surgery. Surgeons need to have an astute clinical acumen in diagnosing internal hernias to avoid repercussions and fatal events.

HERNIE PARADUODENALE DROITE DANS LE SERVICE DE CHIRURGIE DE CHIRURGIE GENERALE DU CENTRE DE SANTE DE REFERENCE DE LA COMMUNE VI DU DISTRICT DE BAMAKO

Right paraduodenal hernia is a cause of bowel obstruction. We rapported a case treated succefully by laparotomy surgery, a 31 years old manwas admited in emergency for severe abdominal pain and abdominal distension. The symtom started 22 hours ago without fever. Physical examinatin found a abdominal pain maximum in the right hypochondrium. The laboratory test was normal. The ASP radiographyshowed the sign of bowel obstruction on the small intestin.Laparotomy surgery was performed in emergency. An hernia orifice was observed near the right side of the ligament of Treitz and 2 meter of small intestin was incarcerated through the orifice into the retroperitonium. There was no bowel gangrenous. There was no postoperative complication and patient was discharged on POD 5. Conclusion : right paraduodenal hernia is a rare cause of bowel obstruction. The peoperative diagnostic is no easy. The laparotomie surgery stay a good approach to resolve this diagnostic and therapeutic problem in ours conditions. Key words : right paraduodenal hernia, laparotomy,emergency, CSRéfCVI

The Management of A Small Bowel Obstruction Caused by A Right Paraduodenal Hernia

Right paraduodenal hernia (RPH) is a type of internal hernia and is frequently associated with intestinal malrotation. The preoperative diagnosis is often difficult. We report the case of a

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.

Left Paraduodenal Hernia: A Rare Cause of Intestinal Obstruction

We report the observation of a patient with acute intestinal obstruction by left para-duodenal hernia without necrosis of the incarcerated small intestines for one patient, treated by reduction of the incarcerated small intestine and resection of the hernial sac. We discuss in this case the diagnostic and therapeutic features of this rare condition.

Left paraduodenal hernia – A diagnostic challenge: Case report

Introduction and importanceInternal hernias represent the penetration of intestinal loops through congenital or acquired openings within the mesentery or peritoneum. One such hernia is the paraduodenal hernia, which is the most common type of internal hernia (53%) (Yun et al., 2010) [1]. Due to the variable and non-specific clinical presentation, it is difficult to make a correct diagnosis. Preoperative computed tomography of the abdomen facilitates diagnosis and timely surgical intervention, which can be performed openly or laparoscopically (Coakley et al., 2012) [2].Case presentationIn this paper, the case of a 39-year-old patient with left paraduodenal hernia will be presented. He arrived in the emergency department with sudden onset of abdominal pain. The diagnosis was established using computed tomography and an open surgical procedure was successfully performed.DiscussionClinical presentation of paraduodenal hernia ranges from asymptomatic to manifest. The greatest difficulty regarding management of paraduodenal hernias lies in their diagnosis. Many studies have shown that the best option for diagnosis is computed tomography (CT). Open and laparoscopic techniques are used in treatment of paraduodenal hernias with similar results.ConclusionThe case of a 39-year-old male patient with LPDH with non-specific symptomatology was presented. CT scan is the best diagnostic option for this condition. Open surgical approach was used with great success.

An interesting case of left paraduodenal hernia.

Paraduodenal fossa hernias (PDFHs) represent 53% of all congenital internal hernias and 0.2-0.9% of all small bowel obstructions. Most of these hernias are diagnosed incidentally on laparotomy, and carry up to 50% lifetime risk of development of small bowel obstruction. We present our experience in diagnosing and treating a case of a massive left paraduodenal fossa hernia in a 17 year male, containing over 30% of the small bowel (jejunum and ileum), presenting with a history of recurrent incomplete small bowel obstruction. Plain abdominal radiography showed distended loops of jejunum and few air fluid levels. After laparotomy and identification of hernia, small gut was reduced and examined, which was found to be structurally and functionally intact with normal vascularity. The defect was closed with continuous absorbable suture (Vicryl 2-0) sparing the inferior mesenteric vessels. Patient’s post-operative recovery remained uneventful and he was discharged on 4th post-operative day.

Left Para-Duodenal Hernia with Intestinal Obstruction by Bridle: A Case Report

Left Para-Duodenal Hernia with Intestinal Obstruction by Bridle: A Case Report