Left paraduodenal hern�a: a report of a case

Polat, Fatin Rüştü; Dinelek, Hasan

doi:10.5505/sakaryamj.2012.46338

Sakarya Med J

2012

DOI: 10.5505/sakaryamj.2012.46338

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Left paraduodenal hern�a: a report of a case

Fatin Rüştü Polat¹,

Hasan Dinelek²

Abstract: Paraduodenal herni ince barsak obstrüksiyonlarının nadir bir nedenidir. Sağ ve sol olarak ikiye ayrılır. Klinik semptomlar değişken, nonspesifik ve zaman zaman akut ince barsak obstrüksiyonu veya iskemisi şeklinde olabilir. Biz bu yazıda akut abdominal ağrı ve bulantı ile acil servise kabul edilen sol paraduodenal herni vakasını sunuyoruz.

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2018

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“…Since then, several successful laparoscopic PDH repairs have been reported in various countries. After searching the national and international literature, we found 22 cases related to adult PDH in Turkey (9,(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30). This is summarized in the Table 1.…”

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A case report of left paraduodenal hernia diagnosed preoperatively and treated laparoscopically

et al. 2018

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Paraduodenal hernia is a rare congenital anomaly; however, it is the most common cause of internal herniation. Clinical findings are often indeterminate. Computerized tomography is usually diagnostic; however, the diagnosis is often made intra-operatively. Paraduodenal hernia carries a risk of incarceration leading to bowel obstruction and strangulation; therefore, it should be repaired surgically when diagnosed. Here we present a case of left PDH that was diagnosed preoperatively and repaired laparoscopically.Keywords: Laparoscopy, paraduodenal, hernia INTRODUCTIONInternal hernias result from the extension of the intestine through a defect within the peritoneum or mesentery (1). They may be either congenital or acquired. Paraduodenal hernia (PDH) is a rare congenital anomaly that results from an error of rotation of the midgut (2). PDHs are the most common form of internal hernias, accounting for 53% of all internal hernias (1, 3). PDHs are difficult to diagnose because the clinical symptoms are variable (4). PDH can begin with symptoms of acute obstruction or recurring abdominal pain (43%) or can be asymptomatic throughout the patient's life. Between 10% and 50% of internal hernias are discovered during unrelated abdominal surgeries or imaging exams and autopsy (5). Preoperative computerized tomography scan of the abdomen is usually diagnostic; however, the diagnosis is often made intra-operatively. Surgical treatment can be performed with traditional open methods or minimally invasive laparoscopic techniques. We describe herein the preoperative radiological diagnosis and successful laparoscopic repair of a left PDH in an adult man. CASE PRESENTATIONA 39-year-old man was admitted to the emergency department with complaints of epigastric cramps and nausea and vomiting that persisted for almost one day. It was known that he had been suffering from similar problems for a long time, and he had applied to 3 different hospitals in the last 10 days. There was no specific finding except for upper left quadrant tenderness. He had no history of abdominal surgery. His vital signs were normal. On his plain abdominal film, vague and limited air-fluid levels and a mass-like lesion were found in the left quadrants. Laboratory results were normal, except his leukocyte count was 11600. He was hospitalized for follow-up. It was noticed that he was comfortable while resting on his left side; however, his pain worsened in the supine position. Encapsulated and moderately dilated small bowel loops were detected in the upper left quadrant between the stomach and pancreas by CT (Figure 1). He was preoperatively diagnosed with left PDH. Four ports were inserted; one 10 mm supraumblical port for the camera, another port 10 mm from the upper left quadrant, and two 5 mm ports in the upper right quadrant. During exploration, left PDH was observed on the left side of Treitz's ligament behind the inferior mesenteric vein. An entrapped jejunum loop of approximately 80 cm was then reduced from the hernia sac into the abdominal cavity with an ...

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A case report of left paraduodenal hernia diagnosed preoperatively and treated laparoscopically

et al. 2018

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Left paraduodenal hern�a: a report of a case

Cited by 1 publication

References 3 publications

A case report of left paraduodenal hernia diagnosed preoperatively and treated laparoscopically

A case report of left paraduodenal hernia diagnosed preoperatively and treated laparoscopically

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