A Case of Right Paraduodenal Hernia Diagnosed by Ct Preoperatively

Abstract

A 37-year-old woman suffering from left upper abdominal pain after dinner on April 17, 1999 was admitted to another hospital on April 18 because the pain intensified. A fist-sized lump with tenderness was palpated in the left lower abdomen on admission. But the lump disappeared after the patient vomited during the night and the pain was relieved. On April 19, ileus due to paraduodenal hernia was suspected from abdominal X-rays and CT scan, and the patient was referred to our hospital for elective surgery. At surgery performed on April 20, a hernia opening 2cm in diameter was present in the right side of the Treitz's ligament, through which about a 90cm leugth of the jejunum had invaginated into the mesenter ium of transverse colon. The jejunum entered into the hernia cavity was returned to the normal position, and the opening was closed. She developed adhesive ileus after the operation but it improved without further operation. She was discharged from the hospital on May 16.A case of paraduodenal hernia, that is a rare inner hernia, is here reported, together with a study of similar cases in Japan.