Left paraduodenal hernia – A diagnostic challenge: Case report

Abstract

Introduction and importance Internal hernias represent the penetration of intestinal loops through congenital or acquired openings within the mesentery or peritoneum. One such hernia is the paraduodenal hernia, which is the most common type of internal hernia (53%) (Yun et al., 2010) [1] . Due to the variable and non-specific clinical presentation, it is difficult to make a correct diagnosis. Preoperative computed tomography of the abdomen facilitates diagnosis and timely surgical intervention, which can be performed openly or laparoscopically (Coakley et al., 2012) [2] . Case presentation In this paper, the case of a 39-year-old patient with left paraduodenal hernia will be presented. He arrived in the emergency department with sudden onset of abdominal pain. The diagnosis was established using computed tomography and an open surgical procedure was successfully performed. Discussion Clinical presentation of paraduodenal hernia ranges from asymptomatic to manifest. The greatest difficulty regarding management of paraduodenal 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 treatment of paraduodenal hernias with similar results. Conclusion The case of a 39-year-old male patient with LPDH with non-specific symptomatology was presented. CT scan is the best diagnostic option for this condition. Open surgical approach was used with great success.

A late presentation of a left paraduodenal hernia in an elderly patient admitted in emergency: A case report

“…PDHs consist of small bowel herniations through the peritoneal sac near the duodenum-jejunal area. They are the most common type of IHs and they are usually divided into two main groups: the right (RPDH) and left LPDH paraduodenal hernia [ 2 – 13 , 16 ]. The LPDH is the most frequent with the HO typically occurring at the level of the Landzert fossa [ 2 , 5 , 11 ].…”

“…Imaging with MDCT continues to play a crucial role in the diagnosis of IHs for its rapidity and for its panoramic view through multiplanar visualizations[ 2 – 13 , 17 – 19 ]. On MDCT, LPDHs usually appear as an encapsulated circumscribed mass of jejunal loops in the left quadrant, lateral to ascending duodenum or just above and exterior to the ligament of Treitz and posterior to the IVM that could be displaced upward [ 2 – 5 ].…”

Intestinal malrotation in adult : a unique case combining parduodenal hernia and complete common mesentery

“…The clinical presentation is non-speci c, and may remain asymptomatic for a long time or present with non-speci c symptoms, such as digestive disorders and chronic abdominal pain, to symptoms of intestinal obstruction [7].…”

From Recurrent Pain to a Life-Threatening Condition: A Case Report of Left Paraduodenal Hernia

“…Radiologists and clinicians are challenged by internal hernias due to their rarity and the complexity of their diagnosis and treatment [ 5 ]. The clinical presentation includes chronic non-specific symptoms such as chronic abdominal pain, constipation, and indigestion over time, posing a diagnostic challenge and leading to more acute presentations, such as acute intestinal obstruction, or a more grave presentation, such as intestinal ischemia and perforation and its sequelae if untreated [ 2 , 6 ].…”

“…Medical history, clinical examination, laboratory diagnostics, and preoperative computed tomography (CT) contribute to the diagnosis. Despite the stated diagnostic possibilities, the final diagnosis is usually made during surgery [ 6 ]. The ultimate modality of treatment is operative repair, either laparoscopic or open repair, depending on the operative facilities and level of competency available [ 3 , 6 ].…”