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. 2018:51:194-199.
doi: 10.1016/j.ijscr.2018.08.050. Epub 2018 Aug 29.

Laparoscopic repair of acute small bowel obstruction due to left paraduodenal hernia: A case report

Masakazu Wakabayashi  1 , Satoru Kono  2 , Tomohide Takahashi  2
Affiliations

Laparoscopic repair of acute small bowel obstruction due to left paraduodenal hernia: A case report

Masakazu Wakabayashi et al. Int J Surg Case Rep. 2018.

Abstract

Introduction: Paraduodenal hernia is a rare disease but the most common internal hernia. Laparoscopic repair of paraduodenal hernia is feasible and effective because of its minimal invasiveness and aesthetic advantage.

Presentation of case: We report a case of a 79 year-old-man who was admitted with a complaint of recurrent left abdominal pain. Computed tomography revealed an encapsulated cluster of jejunum loops in the left upper quadrant, near the ligament of Treitz and at the dorsal side of the inferior mesenteric vein. Emergency laparoscopic surgery was performed. The jejunum loops incarcerated in the hernia sac was reduced. The hernia orifice was closed with interrupted suture. Postoperative period was uneventful and the patient was discharged home on the 7th postoperative day. There has been no recurrence during a follow-up.

Discussion: If there is a working space in the abdominal cavity, laparoscopic surgery for paraduodenal hernia leads to patient's early recovery with cosmetic satisfaction.

Conclusion: Left paraduodenal hernia is a rare cause of small bowel obstruction that should be thought about patient with a history of recurrent abdominal pain. Computed tomography is the standard for a correct diagnosis. Laparoscopic repair as the first surgical option for paraduodenal hernia is feasible despite of technical difficulties.

Keywords: Laparoscopic surgery; Paraduodenal hernia; Small bowel obstruction.

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Figures

Fig. 1
Fig. 1
Horizontal abdominal CT. Enhanced horizontal abdominal CT shows encapsulated cluster of jejunum loops in the left upper quadrant surrounded by hernia sac (arrowhead) posterior to the inferior mesenteric vein (arrow).
Fig. 2
Fig. 2
Coronal abdominal CT. Enhanced coronal abdominal CT shows encapsulated cluster of jejunum loops in the left upper quadrant (arrowhead).
Fig. 3
Fig. 3
Laparoscopic surgical findings. The hernia orifice was found near the ligament of Treitz, posterior to the inferior mesenteric vein (arrowhead). It was 5 cm sized in diameter.
Fig. 4
Fig. 4
Laparoscopic surgical findings. The hernia orifice was closed intracorporeally with 4 interrupted suture.
See this image and copyright information in PMC

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