Computed tomography diagnosis of symptomatic right paraduodenal hernia associated with enteric duplication cyst

Prada-Arias, Marcos; Sanchís-Solera, L.; Pérez-Candela, V.; Wiehoff-Neumann, A.; Alonso-Jiménez, L.; Beltrá-Picó, R.

doi:10.1016/j.jpedsurg.2007.08.004

Cited by 11 publications

(2 citation statements)

References 17 publications

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“…CT or magnetic resonance imaging may assist in the diagnosis and localization of the mass. [ 16 19 ] Radionuclide scanning can be used in cases with suspicion of heterotopic gastric mucosa. [ 20 ]…”

Section: Discussionmentioning

confidence: 99%

Gastrointestinal Duplications

Gupta

Kumar

Agrawal

et al. 2023

Journal of Indian Association of Pediatric Surgeons

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A BSTRACT Context: Gastrointestinal (GI) duplications are rare congenital malformations with diverse presentations. They usually present in the pediatric age, especially in the first 2 years of life. Aims: To present our experience with GI duplication (cysts) at a pediatric surgery tertiary care teaching institute. Settings and Design: It is a retrospective observational study undertaken in the department of pediatric surgery at our center between 2012 and 2022 for GI duplications. Materials and Methods: All children were analyzed for their age, sex, presentation, radiological evaluation, operative management, and outcomes. Results: Thirty-two patients were diagnosed with GI duplication. Slight male predominance was present in the series (M: F ≈ 4:3). Fifteen (46.88%) patients presented in the neonatal age group; 26 (81.25%) patients were under 2 years. In the majority of cases ( n = 23, 71.88%), the presentation was acute onset. Double duplication cysts on opposite sides of the diaphragm were present in one case. The most common location was ileum ( n = 17), followed by gallbladder ( n = 6), appendix ( n = 3), gastric ( n = 1), jejunum ( n = 1), esophagus ( n = 1), ileocecal junction ( n = 1), duodenum ( n = 1), sigmoid ( n = 1), and anal canal ( n = 1). Multiple associations (malformations/surgical pathologies) were present. Intussusception ( n = 6) was the most common, followed by intestinal atresia ( n = 5), anorectal malformation ( n = 3), abdominal wall defect ( n = 3), hemorrhagic cyst ( n = 1), Meckel's diverticulum ( n = 1), and sacrococcygeal teratoma ( n = 1). Four cases were associated with intestinal volvulus, three cases with intestinal adhesions, and two with intestinal perforation. Favorable outcomes were present in 75% of cases. Conclusion: GI duplications have varied presentations depending on site, size, type, local mass effect, mucosal pattern, and associated complications. The importance of clinical suspicion and radiology cannot be underrated. Early diagnosis is required to prevent postoperative complications. Management is individualized as per the type of duplication anomaly and its relation with the involved GI tract.

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Section: Discussionmentioning

confidence: 99%

Gastrointestinal Duplications

Gupta

Kumar

Agrawal

et al. 2023

Journal of Indian Association of Pediatric Surgeons

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“…Paraduodenal hernia occurs three times more often in men [4-6]. It has two main types, left-sided and right-sided, with the left-sided type accounting for 75% of reported cases [2].…”

Section: Discussionmentioning

confidence: 99%

A causal relationship between right paraduodenal hernia and superior mesenteric artery syndrome: a case report

Fukada

Mukai²,

Shimamura³

et al. 2010

J Med Case Reports

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IntroductionCases of right paraduodenal hernia and superior mesenteric artery syndrome have been reported separately, but their occurrence in combination has not been reported.Case presentationA 46-year-old Japanese man who had never undergone laparotomy was admitted to our hospital due to an acute abdomen. An enhanced multidetector-row computed tomography scan of our patient showed a cluster of small intestines with ischemic change in his right lateral abdominal cavity. Emergency surgery was subsequently performed, and strangulation of the distal jejunum along with incidental right paraduodenal hernia was found. His necrotic ileum was resected, and the jejunum encapsulated by the sac was repaired manually without reduction.Three days after the operation, however, our patient developed vomiting. An upper gastrointestinal series revealed a straight line cut-off sign on the third portion of his duodenum. A second enhanced multidetector-row computed tomography scan showed that he had a lower aortomesenteric angle and a shorter aortomesenteric distance compared to his condition before his right paraduodenal hernia was surgically repaired. We strongly suspected that the right paraduodenal hernia repair may have induced superior mesenteric artery syndrome. On the 21st post-operative day, duodenojejunostomy was performed because conservative management had failed.ConclusionsIn this case, enhanced multidetector-row computed tomography, which permits reconstructed multiplanar imaging, helped us to visually identify these diseases easily. It is important to recognize that surgical repair of a right paraduodenal hernia may cause superior mesenteric artery syndrome.

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