Description
A 59-year-old male patient presented acuetly with small bowel
obstruction. An abdominal CT scan was performed showing left
para-duodenal hernia with an incarcerated jejunal and ileal loops
upstream of a single transitional level of the last ileal loop located
at the level of the hypogastrium. The diagnosis of acute intestinal
obstruction related to paraduodenal hernia was suspected, so we decided
to operate the patient. Laparotomy revealed a left paraduodenal hernia
(Figure 1) with most of the small bowel herniating through a space
between the inferior mesenteric vein and duodenojejunal junction with
necking in the last loop (Figure 2). The small bowel was reduced from
the hernia and the defect of the mesentery was repaired using sutures.
Paraduodenal hernia (PDH) are responsible for only 0,2-0,9 % of all the
cases of intestinal obstruction [1]. Surgical correction remains the
main treatment of PDH. This image has an emphasis on one of the three
techniques used for paraduodenal hernia repair: excision of the hernia
sac with subsequent closure of the hernia defect [2]. The other
operative approaches are closure or enlargement of defect