DOI: https://dx.doi.org/10.18203/2349-2902.isj20220747
Published: 2022-03-28

Para-duodenal hernia: a rare case report

Deep Parkash Talreja, Hamed Humayid Al Aamri, Parwez Waseemul Haque, Ayman Ahmad Albatanony

Abstract


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.


Keywords


Para-duodenal hernia, Treitz hernia, Internal hernia, Intestinal obstruction, Hernia

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References


Schizas D, Apostolou K, Krivan S, Kanavidis P, Katsaros I, Vailas M et al. Paraduodenal hernias: a systematic review of the literature. Hernia. 2019;23(6):1187-97.

Newson BD, Kukora JS. Congenital and acquired internal hernias: unusual causes of small bowel obstruction. Am J Surg. 1986;152(3):279-85.

Ghahremani GG. Internal abdominal hernias. Surg Clin North Am. 1984;64:393-406.

Bartlett MK, Wang C, Williams WH. The surgical management of paraduodenal hernia. Ann Surg. 1968;168(2):249-54.

Tepeňás M, Kirac I, Glavan E, Doko M. Internal hernias in acute abdomen: a review of literature and report of four cases. Coll Antropol. 2015;39(2):475-9.

Bouchentouf SM, Raissouni F, El Kaoui H. Intestinal obstruction due to a left paraduodenal hernia: a case report J Med Case Rep. 2013;7:272.

Khan MA, Lo AY, Vande Maele DM. Paraduodenal hernia. Am Surg. 1998;64:1218-22.

Okan I, Ozkan OV, Sahin M, Bas G, Alimoglu O. Left paraduodenal hernia diagnosed preoperatively, ANZ J Surg. 2010;80:116.

Ostaz MF, Ozturk CE, Yagci A. A rare pathology that caused high-level intestinal obstruction: left paradupodenal hernia. Ulus Cerrahi Derg. 2013;29:92-5.

Agha RA, Fowler AJ, Saetta A, Barai I, Rajmohan S, Orgill DP. for the SCARE Group the SCARE statement: consensus-based case report guidelines. Int J Surg. 2016;34:180-6.

Blachar A, Federle MP, Dodson SF. Internal hernia: clinical and imaging findings in 17 patients with emphasis on CT criteria. Radiology. 2001;218:68-74.

Aggarwal S, Birchall J, Rowlands TE, Al-khyatt W. Acute intestinal obstruction secondary to left paraduopdenal hernia: a case report and literature review. World J Emerg Surg. 2013;8:5.

Parmar BO, Parmar RS. Laparoscopic management of left paraduodenal hernia. J Minim Access Surg. 2010;6(4):122-4.

Akn M, Kurukahvecioglu O, Bostanci H, Anadol AZ, Taneri F. Left paraduodenal hernia caused by a peritoneal membrane: report of a case. Erciyes Med J. 2009: 29-32.

Arslan K, Dogru O, Koksal H, Atay A. A rare cause of intestinal obstructions: left paraduodenal hernia, in Case Study and Case Rep. 2012;2:137-42.