scholarly journals Left Paraduodenal Hernia Presenting as Closed Loop Jejunal Obstruction in a Young Female: An Enigmatic and Perilous Differential of Acute Abdomen

2021 ◽  
Vol 07 (03) ◽  
pp. e212-e215
Author(s):  
Deepak Rajput ◽  
Ankit Rai ◽  
Amit Gupta ◽  
Subramanian Chezhian ◽  
Shashank Kumar ◽  
...  
Keyword(s):  
Intestinal Obstruction ◽  
Internal Hernia ◽  
Young Female ◽  
Paraduodenal Hernia ◽  
Potential Space ◽  
Mortality And Morbidity ◽  
Internal Hernias ◽  
Jejunal Obstruction ◽  
Prompt Diagnosis ◽  
Significant Mortality

AbstractInternal hernia is a rare cause of intestinal obstruction, accounting for <2% of cases with paraduodenal type being the most common. An internal hernia, mostly acquired, develops due to protuberance of the intestine through a gap in the peritoneum or mesentery formed as a result of an antecedent abdominal operation such as gastric bypass or liver transplant, ischemic injury, peritonitis, or trauma. Paraduodenal hernias (PDHs) are congenital anomalies, secondary to a failed fusion of mesentery with parietal peritoneum along with rotational midgut errors, causing the evolution of potential space for herniation within the left paraduodenal fossa. Primary internal hernias can have a varied clinical presentation and cause significant mortality and morbidity if left untreated. We report the case of a 20-year-old female with chronic pain in abdomen and intestinal obstruction due to left PDH (LPDH). The prompt diagnosis led to timely exploration and reduction of entrapped jejunum, with prudent closure of the hiatus, while circumventing any injury to the adjacent mesenteric circulation. No postoperative ileus arose, and recovery was uneventful.

scholarly journals PARADUODENAL HERNIA- AN OBSCURE AND PERILOUS CAUSE OF INTESTINAL OBSTRUCTION.

2020 ◽  
Vol 4 (6) ◽  
Author(s):  
Rajesh Kumar Soni ◽  
Dharmendra Kumar Patel ◽  
Ashwani Gupta ◽  
Raghav Garg ◽  
Ratnakar Namdeo
Keyword(s):  
Abdominal Surgery ◽  
Intestinal Obstruction ◽  
Internal Hernia ◽  
Gold Standard ◽  
Exploratory Laparotomy ◽  
Paraduodenal Hernia ◽  
Internal Hernias ◽  
Posterior Parietal ◽  
Left And Right ◽  
Prompt Diagnosis

Paraduodenal hernias (PDH) constitute more than half of internal hernias. Both left and right PDH occur due to error of rotation of gut and defective fusion of mesocolon and mesentery with posterior parietal peritoneum.  Clinical diagnosis of PDH is very difficult because of its varied presentation and nonspecific symptoms. Prompt diagnosis and surgery is imperative to avoid strangulation of bowel which is associated with high mortality. Before the advent of CECT many were discovered during exploratory laparotomy or unrelated abdominal surgery. Now CECT abdomen has become the gold standard for pre-operative diagnosis of PDH. We report two cases of PDH, one on left side and another on right side, diagnosed preoperatively and treated successfully. Keywords: Paraduodenal hernia, Mesocolic hernia, Treitz hernia, Internal hernia

scholarly journals LEFT PARA-DUODENAL HERNIA

2016 ◽  
Vol 23 (02) ◽  
pp. 238-240
Author(s):  
Asrar Ahmad ◽  
Irum Saleem ◽  
Nisar Ahmed ◽  
Farrukh Ayub
Keyword(s):  
Intestinal Obstruction ◽  
Internal Hernia ◽  
High Index ◽  
Paraduodenal Hernia ◽  
Internal Hernias ◽  
High Index Of Suspicion

Internal hernia is defined as herniation of viscera through a defect in themesentery or peritoneum. Internal hernias can cause intestinal obstruction. Paraduodenalhernias though a rare cause of intestinal obstruction, are more common on the left side. Thesehernias may cause strangulation and gangrene of the intestines so a high index of suspicion isrequired for diagnosis. Treatment is always surgical. We hereby report a case of acute intestinalobstruction due to left paraduodenal hernia.

scholarly journals LEFT PARADUODENAL HERNIA: A CASE REPORT OF RARE CAUSE OF INTESTINAL OBSTRUCTION

2021 ◽  
Vol 9 (01) ◽  
pp. 186-188
Author(s):  
Ahbala T. ◽  
◽  
Rabbani K. Lammat H ◽  
Louzi A ◽  
◽  
...  
Keyword(s):  
Intestinal Obstruction ◽  
Internal Hernia ◽  
University Hospital ◽  
Paraduodenal Hernia ◽  
Diagnostic Challenge ◽  
Rare Type ◽  
Internal Hernias ◽  
Uncommon Condition ◽  
Surgery Department ◽  
Hospital Center

Internal hernia is a relatively uncommon condition and is a rare type of intestinal obstruction. Paraduodenal hernia is considered the most common type of internal hernias. The rare prevalence and the variable symptoms make the clinical diagnosis of paraduodenal hernia a diagnostic challenge. We present the case of acute intestinal obstruction by left para-duodenal internal hernia treatedat the general surgery department of the Mohammed VI University Hospital Center in Marrakech, Morocco inorder to contribute to the knowledge of the clinical particularities of this entity.

scholarly journals Internal Incarceration of Left Paraduodenal Hernia with Necrosis of Proximal Jejunum and Atypical Reconstruction of the Passage: A Case Report

2013 ◽  
Vol 6 (2) ◽  
pp. 139-142
Author(s):  
Pentcho T. Tonchev ◽  
Sergei D. Iliev ◽  
Ivailo M. Presolski
Keyword(s):  
Case Report ◽  
Intestinal Obstruction ◽  
Internal Hernia ◽  
Proximal Portion ◽  
Paraduodenal Hernia ◽  
Proximal Jejunum ◽  
Radiological Findings ◽  
Transverse Mesocolon ◽  
Internal Hernias ◽  
Purulent Peritonitis

Summary Internal hernias are rare and most of them are diagnosed intraoperatively. We present a case of a 53-year-old man with proximal intestinal obstruction, caused by incarcerated internal hernia. During the operation, a proximal portion of 40 cm of the jejunum was found herniated and strangulated in the lesser sac through an opening of the transverse mesocolon. The jejunum was necrotic and local purulent peritonitis was present. After resection of the proximal 40 cm of the jejunum, the passage was restored using an unconventional approach. The distal duodenum was closed and, to protect the stump, the duodenum was ligated between its second and third parts. A latero-lateral anastomosis was made between the first part of duodenum and the jejunum. Anatomical, clinical and radiological findings, diagnosis and treatment of paraduodenal hernias are discussed in brief.

Hernia interna estrangulada por plastrón en el tercio distal del apéndice cecal

2019 ◽  
Vol 62 (6) ◽  
pp. 24-27
Author(s):  
Leslie M. Leyva Sotelo ◽  
José E. Telich Tarriba ◽  
Daniel Ángeles Gaspar ◽  
Osvaldo I. Guevara Valmaña ◽  
André Víctor Baldín ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Early Diagnosis ◽  
Intestinal Obstruction ◽  
Acute Abdomen ◽  
Internal Hernia ◽  
Wide Spectrum ◽  
Internal Hernias ◽  
Mild Abdominal Pain ◽  
Made In

Internal hernias are an infrequent cause of intestinal obstruction with an incidence of 0.2-0.9%, therefore their early diagnosis represents a challenge. The most frequently herniated organ is the small bowel, which results in a wide spectrum of symptoms, varying from mild abdominal pain to acute abdomen. We present the case of an eight-year old patient with nonspecific digestive symptoms, a transoperative diagnosis was made in which an internal hernia was found strangulated by plastron in the distal third of the appendix. Appendectomy was performed and four days later the patient was discharged without complications.

scholarly journals Strangulated internal hernia through the lesser omentum with intestinal necrosis: a case report

2002 ◽  
Vol 120 (3) ◽  
pp. 84-86 ◽  
Author(s):  
Gustavo Gibin Duarte ◽  
Belchor Fontes ◽  
Renato Sérgio Poggetti ◽  
Marcos Roberto Loreto ◽  
Paulo Motta ◽  
...  
Keyword(s):  
Case Report ◽  
Intestinal Obstruction ◽  
Internal Hernia ◽  
Clinical Manifestations ◽  
Acute Intestinal Obstruction ◽  
Main Task ◽  
Intestinal Necrosis ◽  
Lesser Omentum ◽  
Lesser Sac ◽  
Internal Hernias

CONTEXT: Internal hernias account for only 0.2 to 0.9% of the cases of intestinal obstruction. They do not have specific clinical manifestations, and are usually diagnosed during laparotomy for acute intestinal obstruction. Internal hernias through the lesser omentum are extremely rare. CASE REPORT: We report here the case of a 36-year-old patient who underwent exploratory laparotomy for acute intestinal obstruction. An internal hernia through the lesser omentum was found, with a strangulated ileal segment passing through the perforation into an abscess within the lesser sac. The surgical procedures included ileal resection, primary anastomosis, abscess removal, and placement of a drain in the lesser sac. The patient was reoperated 6 days later for abdominal sepsis; a lesser sac abscess was removed and the abdominal incision was left open. The patient stayed in the Intensive Care Unit for 15 days, and eventually left the hospital on the 28th post-admission day, with complete recovery thereafter. CONCLUSION: The early diagnosis of acute intestinal obstruction and immediate indication for laparotomy is the main task of the surgeon when faced with a case of acute abdomen with a hypothesis of internal hernia, so as to minimize severe postoperative complications, as illustrated by the present case.

Internal Hernia: Postoperative Complication of Roux-en-Y Gastric Bypass Surgery

2006 ◽  
Vol 72 (7) ◽  
pp. 581-585 ◽  
Author(s):  
Aaron Eckhauser ◽  
Alfonso Torquati ◽  
Yassar Youssef ◽  
Joan L. Kaiser ◽  
William O. Richards
Keyword(s):  
Gastric Bypass ◽  
Length Of Stay ◽  
Intestinal Obstruction ◽  
Internal Hernia ◽  
The United States ◽  
Morbidity And Mortality ◽  
Transverse Mesocolon ◽  
Surgical Morbidity ◽  
Internal Hernias ◽  
Clinical Awareness

Obesity surgery is becoming one of the most common general surgery procedures done in the United States. Internal hernias are a known and increasingly more common occurrence after laparoscopic roux-en-Y gastric bypass (LRYGB). Increased clinical awareness of this complication will lead to decreased surgical morbidity and mortality. We retrospectively reviewed our database of 529 patients who had undergone LRYGB from 2000 to 2005 and identified those presenting with intestinal obstruction from an internal hernia. The type of internal hernia (jejunojejunostomy, transverse mesocolon, roux limb mesentery [Peterson's hernia]), length of time from presentation to operative intervention, and length of stay were obtained for all patients. Of 529 laparoscopic retrocolic retrogastric LRYGBs, 13 internal hernias (2.5%) were identified in 13 different patients. Eight of the hernias were at the mesenteric defect created by the jejunojejunostomy (62%), 3 originated from the transverse mesocolon defect (23%), and 2 were a Peterson's hernia (15%). The median time from initial operation to repair was 150 days. The average time from presentation to operative repair was 29.2 hours (range, 5–67.5 hours). The median length of stay was 3 days (range, 1.5–45 days). Eleven hernias were repaired laparoscopically (85%). There were no mortalities associated with obstruction from the internal hernia. Intestinal obstruction from an internal hernia after LRYGB is becoming increasingly more common. General awareness of this condition and high clinical suspicion allow for prompt surgical intervention with decreased morbidity and mortality.

scholarly journals Inverted bladder diverticulum with sigmoid colon herniation masquerading as bowel and bladder obstruction

2018 ◽  
Vol 5 (11) ◽  
pp. 3767
Author(s):  
Pratima . ◽  
Abhilash . ◽  
Suma S ◽  
Krishna Prasad
Keyword(s):  
Intestinal Obstruction ◽  
Sigmoid Colon ◽  
Internal Hernia ◽  
Bladder Diverticulum ◽  
Surgical Experience ◽  
Bladder Obstruction ◽  
Internal Hernias ◽  
Abdominal Organs ◽  
Bladder Diverticula ◽  
Primary Bladder

Urinary bladder diverticula can be congenital or acquired, and the latter tends to occur in older men and results from urinary obstruction. Primary bladder diverticula are congenital, smooth walled, solitary in nature and rarely diagnosed in adults. An internal hernia (IH) is a protrusion of intestines or other abdominal organs through a normal or abnormal orifice in the peritoneum or mesentery, occasionally leading to strangulation or incarceration. Internal hernias (IH) are rare causes of acute abdomen and intestinal obstruction in adults. Here we present a case report detailing the authors' surgical experience with inverted bladder diverticulum, presenting as internal hernia with sigmoid colon herniating through it, with features of acute intestinal obstruction and urinary dysfunction.

scholarly journals Congenital Internal Hernia: Rare Cause of Acute Abdominal Pain

2021 ◽  
pp. 791-794
Author(s):  
Jay Patel ◽  
Antoine Hamedi ◽  
Muhammad Khalil ◽  
Jessica El-Bahri
Keyword(s):  
Abdominal Pain ◽  
Early Diagnosis ◽  
Internal Hernia ◽  
Poor Prognosis ◽  
Surgical Intervention ◽  
Acute Abdominal Pain ◽  
Rare Condition ◽  
Internal Hernias ◽  
Congenital Internal Hernia ◽  
Prompt Diagnosis

Acute abdominal pain is a common presenting symptom that possesses a wide differential. Congenital internal hernias are a rare condition that often presents with abdominal pain and can lead to obstruction. Early diagnosis is often difficult and therefore can present acutely and in an emergent setting. Prompt recognition of symptoms and evaluation are important to prevent poor prognosis. We are presenting a case of a congenital internal hernia in a patient presenting with nonspecific symptoms. Prompt diagnosis and subsequent surgical intervention allowed for appropriate management and resolution of symptoms.

scholarly journals A Unique Case of Small Bowel Internal Hernia and Volvulus Caused by a Hamartoma

2021 ◽  
Vol 07 (03) ◽  
pp. e209-e211
Author(s):  
Charif Khaled ◽  
Michel Akl ◽  
Toufic Moussallem
Keyword(s):  
Small Bowel ◽  
Literature Review ◽  
Intestinal Obstruction ◽  
Internal Hernia ◽  
Young Female ◽  
Unique Case ◽  
Diagnosis And Management ◽  
Small Bowel Hamartoma

AbstractThis study depicts the case of a young female presenting with intestinal obstruction. Surgery uncovered a small bowel hamartoma that has caused a transmesenteric internal hernia and volvulus. As far as we know, this is unheard of before, as all three mentioned entities are very rare. The study also covers a literature review of cases of internal hernia with volvulus and stresses over the need for urgent diagnosis and management.

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