Internal herniation is a rare cause of acute abdomen. If it is not diagnosed and treated in time, it can cause death. This case report discusses the clinical findings and surgical treatment of a case of left paraduodenal hernia, a rare cause of internal herniation. The diagnosis and treatment process of a 24-year-old female patient with ileus findings was retrospectively evaluated and presented in the literature. The patient was operated on with a preliminary diagnosis of internal herniation and the definitive diagnosis was made intraoperatively. At laparotomy, it was observed that almost all of the small intestines herniated posteriorly from the left paraduodenal region. Small intestinal loops were reduced and the hernia sac defect was primarily repaired. The patient was discharged on the fifth postoperative day with complete recovery. Left paraduodenal hernia is a type of internal herniation that should be considered in the differential diagnosis of patients with recurrent abdominal pain and intestinal obstruction. Surgical reduction and primary repair of the defect is an appropriate treatment.
The incidence of urinary bladder hernia accompanying inguinal hernias is 1-4%. Herniation of the urinary bladder into the inguinal canal and scrotum can cause urinary retention and hydronephrosis, bladder necrosis, and renal dysfunction. This study presents a case that underwent emergency surgery for an incarcerated inguinal hernia. The hernia sac included the urinary bladder in addition to bowel segments. An attempt to save the ischemic bladder wall during partial bowel resection failed, and the patient developed a vesicocutaneous fistula. The fistula was repaired, and the ischemic bladder wall was resected. During the repair of an inguinal hernia, general surgeons and urologists must be aware of this rare condition and work together in terms of patient management. Although the bladder-sparing approach can be performed in cases without signs of severe bladder ischemia, patients should be followed closely for complications related to ischemia.
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