Left paraduodenal hernia - A diagnostic challenge: Case report

Int J Surg Case Rep. 2021 Aug:85:106138. doi: 10.1016/j.ijscr.2021.106138. Epub 2021 Jun 29.

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.

Keywords: Case report; Internal hernia; Paraduodenal hernia.