Small Bowel Obstruction Caused by an Unusual Variant of Paraduodenal Hernia. The “Middle Congenital Mesocolic Hernia”: Case Report (original) (raw)
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Congenital middle mesocolic hernia – An unusual cause of small bowel obstruction
Hellenic Journal of Surgery, 2017
Internal herniation is a rare cause of small bowel obstruction, with an incidence of 0.2-0.9%. Obstruction due to congenital internal hernias is even rarer. The commonest type of congenital internal hernia is the paraduodenal or the mesocolic hernia. The left and right mesocolic hernias constitute 75% and 25% of the mesocolic hernias respectively. Middle mesocolic hernias are an extremely rare and unusual variant of mesocolic hernia, and literature search revealed only three reported cases. In view of its rarity, a high level of clinical suspicion, supported by radiological evidence is required to diagnose it preoperatively. Prompt surgical management is mandatory to reduce complications and their associated morbidity and mortality.
A case of a paraduodenal hernia with a concomitant mesosigmoid defect
Central European Journal of Medicine, 2012
Introduction. Intestinal obstruction by congenital internal hernia is rare and unsuspected. Case report. We report the case of a 45 years-old-man diagnosed to have an intestinal obstruction caused by a double concomitant internal hernia. CT scan can provide a fast diagnosis in order not to delay the surgical intervention: the ileum had been entrapped into a big internal hernia between the transverse and the descending colon and the patient was diagnosed to have a paraduodenal hernia. During the intervention a concomitant mesosigmoid defect was found. Results. Our patient had a left paraduodenal hernia with much of the small bowel crowned into a round peritoneal membrane just in front and left to the duodenum and pancreas and between the transverse and descending colon. CT scan showed encapsulated cluster of small bowel loops in the hernia sac. He was taken up for surgery and an urgent laparoscopic access was performed for definitive diagnosis and treatment 4 days after the beginning of the symptoms.
Right paraduodenal hernia leading to bowel strangulation
Journal of Pediatric Surgery, 2011
Up to half of all internal hernias are caused by paraduodenal hernia, a rare congenital midgut malrotation that accounts for less than 1% of all intestinal obstructions. The diagnosis may arise from an incidental finding on abdominal imaging or the patient may present with abdominal pain, vomiting, and obstipation. Early recognition and management of this disease entity are keys because serious complications such as bowel ischemia and infarction may result from a delay in diagnosis. We present a case involving a 14-year-old boy with gangrenous small bowel secondary to right paraduodenal hernia.
A rare cause of small bowel obstruction in adults: left paraduodenal internal hernia
2012
A 47 years old lady presented with repeated intermittent, colicky, left upper, and periumblical abdominal pain associated with nausea and vomiting since two years prior to admission. Each episode of the pain spontaneously subsided after bilious vomiting. The patient had no history of surgery, abdominal trauma or intra-abdominal infection, weight loss or previous history for small bowel obstruction (SBO). MRI enterography was suggestive of internal hernia and surgery documented left paraduodenal (mesocolic) internal hernia (LPDIH). After surgery the patient was followed for three months without any abdominal symptoms. KEywORDS Congenital hernia; Paraduodenal (mesocolic) internal hernia; Small bowel obstruction (SBO).
A paraduodenal hernia revealed by bowel obstruction: case report and literature review
Pan African Medical Journal, 2018
Internal hernias are defined as the protrusion of abdominal viscera through an aperture in the intraperitoneal recesses, they are considered as a rare cause of intestinal obstruction. The paraduodenal hernias are the most common type of congenital hernia especially the left-sided ones. We report a case of a 46 year-old man presenting a left paraduodenal hernia with acute small bowel obstruction, which was firstly (preoperatively) assigned to a tumoral cause.
Intestinal obstruction due to a left paraduodenal hernia: a case report
Journal of Medical Case Reports, 2013
Introduction: A left paraduodenal hernia is a rare congenital malrotational anomaly of the midgut that occurs in the paraduodenal fossa of Landzert to the left of the fourth duodenum. It is responsible for approximately 1% of small bowel obstructions. Case presentation: We report a case of left paraduodenal hernia combined with small bowel obstruction in a 47-year-old Mediterranean woman who had a history of recurrent abdominal pain. An abdominal computed tomography scan showed a saclike mass clustered in the left upper quadrant but failed to yield a clear diagnosis. We describe the surgical anatomy of this disease and the emergency surgical management together with a short review of the literature. Conclusions: Even though a left paraduodenal hernia is rare, it must be suspected in any upper intestinal occlusion. The high morbidity and mortality rate of complicated cases should motivate preventive treatment in case of incidental operative discovery.
Left Para duodenal Hernia: Case Report of Rare Cause of Small Bowel Obstruction
EAS Journal of Medicine and Surgery, 2022
Para duodenal hernia [PDH], a rare congenital anomaly, is a type of internal hernia which occurs due to a defect in the reduction and rotation of the midgut. We present the case of a 32-year-old female patient presented with a seven-day history of generalized intermittent colicky abdominal pain accompanied by multiple episodes of bilious vomiting. She was otherwise healthy and had no history of previous abdominal operations. Computed tomography scan of the abdomen demonstrated sac-like clustered small bowel loops noted in the left upper quadrant, in the anterior para-renal space, consistent with the diagnosis of left Para duodenal hernia. Exploratory Laparotomy for the repair of the hernia was planned. The jejunal loops had herniated through the fossa of Waldeyer. Reduction of hernia contents and excision of the hernia sac was carried out. The patient tolerated the procedure without complications, and she was asymptomatic in the follow-up visit. This case sheds light on the importan...
World Journal of Emergency Surgery, 2013
Introduction: An internal hernia is a protrusion of bowel through a normal or abnormal orifice in the peritoneum or mesentery. Although they are considered as a rare cause of intestinal obstruction, paraduodenal hernias are the most common type of congenital hernias. Methods: A literature search using PubMed was performed to identify all published cases of left paraduodenal hernia (LPDH). Results: In Literature search between 1980 and 2012 using PubMed revealed only 44 case reports before the present one. Median age was 47 years (range 18-82 years). Nearly 50% reported previous mild symptoms. Two-third of patients required emergency surgery in form of laparotomy or laparoscopic repair. Reduction of hernia contents with widening or suture repair of the hernia orifice were the most common standards in surgical management of LPDH. Conclusion: Intestinal obstruction secondary to internal hernias is a rare presentation. High index of suspicion and preoperative imaging are essential to make an early diagnosis in order to improve outcome.