Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013;4(4):412-5.
doi: 10.1016/j.ijscr.2012.11.027. Epub 2013 Jan 28.

Rare small bowel obstruction: Right paraduodenal hernia. Case report

Simone Manfredelli  1 , Zitelli Andrea, Pontone Stefano, Leonetti Giovanni, Marcantonio Maria, Forte Angelo, Angelici Alberto, Mancini Renato
Affiliations

Rare small bowel obstruction: Right paraduodenal hernia. Case report

Simone Manfredelli et al. Int J Surg Case Rep. 2013.

Abstract

Introduction: Paraduodenal hernia (paramesocolic hernia), a rare congenital anomaly due to a midgut malrotation during fetal development, is recognized as the most frequent internal hernias. Two variants have been described: left and right, the latter less common than the first one.

Presentation of case: We report a right paraduodenal hernia case in a 86 years old female patient who developed an acute bowel obstruction syndrome. Final diagnosis was achieved by imaging techniques as abdomen X-ray and CT and confirmed only after surgical operation.

Discussion: Surgical approach was via median laparotomy, consisting in hernia reduction, replacement and stitching of the bowel in its anatomical orientation, and fixing of the posterior wall defect. At 15 months follow-up from surgical procedure the patient is asymptomatic.

Conclusion: Paraduodenal hernia is a rare pathology but its involvement in bowel obstruction syndrome should be always taken into account during diagnostic process.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Coronal drawing of abdominal recessum and fossae (arrows and lines). (A and B) Landzert's fossae. IMA, inferior mesenteric artery; IMV, inferior mesenteric vein; LCA, left colic artery; SMV, superior mesenteric vein. (C) Superior + inferior duodenal hernias. MCA, middle colic artery. (D) Waldeyer's fossae. (E) Transmesocolic fossae.
Fig. 2
Fig. 2
CT scan with small bowel ansa sovradistension, fluid levels presence among bowel segments (arrows) and thickening in mesentery walls (arrows head).
Fig. 3
Fig. 3
Intraoperative findings: hernia orifice along Treitz's ligament.
Fig. 4
Fig. 4
Ischemic suffering of small bowel ansa.
Fig. 5
Fig. 5
Termino-terminal anastomosis after intestinal resection.
See this image and copyright information in PMC

References

    1. Stern L.E., Warner B.W. Congenital internal abdominal hernias: incidence and management. In: Fitzgibbons R.J., Greenburg A.G., editors. Nyhus and condon's hernia. 5th ed. Lippincott Williams and Wilkins; Philadelphia: 2002.
    1. Treitz W. Credner; Prague: 1857. Hernia retroperitonealis. Ein Beitrag zur Geschichte innerer Hernien.
    1. Jonnesco T. Legrosnier et Babe; Paris: 1889. Anatomie topographique du duodenum et hernies duodenales.
    1. Murray H.O. Left paraduodenal hernia. Canadian Medical Association Journal. 1955;72(4):263–267. - PMC - PubMed
    1. Desjardins A.U. Left paraduodenal hernia. Annals of Surgery. 1918;67(2):195–201. - PMC - PubMed