A Case of Strangulated Ileus Caused by Intramesosigmoid Hernia with Left Paraduodenal Hernia

We report a case of right paraduodenal hernia with strangulation of almost the entire small bowel at presentation. Since resection of all bowel of doubtful viability would have resulted in too little residual length to sustain life, a Bogota bag was fashioned using transparent plastic material from an urine drainage bag and the patient monitored intensively for 18 hours. At re-laparotomy, clear demarcation lines had formed with adequate length of viable bowel (100 cm) and resection with anastomosis was done with a good outcome on follow-up, 9 months after surgery. Our description of a rare cause of strangulated intestinal obstruction and a novel method of maximising length of viable bowel is reported for its successful outcome in a low-resource setting.

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Strangulation of an Obstructed Left Paraduodenal Hernia: A Case Report

Hellenic Journal of Surgery ◽

10.1007/s13126-020-0577-0 ◽

2020 ◽

Vol 92 (5-6) ◽

pp. 198-200

Author(s):

Naveen Kumar Polavarapu ◽

Neeti Kapur ◽

Udit Khurana ◽

Arvind Kumar Shekar

Keyword(s):

Case Report ◽

Paraduodenal Hernia

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Laparoscopic reduction and repair of a left paraduodenal hernia

BMJ Case Reports ◽

10.1136/bcr-2019-232098 ◽

2019 ◽

Vol 12 (12) ◽

pp. e232098 ◽

Cited By ~ 1

Author(s):

Takashi Sakamoto ◽

Alan Kawarai Lefor

Keyword(s):

Abdominal Pain ◽

Laparoscopic Repair ◽

Recurrent Abdominal Pain ◽

Paraduodenal Hernia ◽

Enhanced Ct ◽

History Of ◽

Congenital Internal Hernia ◽

Continuous Closure ◽

Hernia Orifice ◽

Similar Episode

Left paraduodenal hernias are the most common type of congenital internal hernia, but they are difficult to diagnose without appropriate imaging. A 79-year-old man with a history of recurrent abdominal pain had another similar episode of abdominal pain, which prompted him to seek evaluation. The pain resolved spontaneously on arrival to the hospital. Enhanced CT scan showed the characteristic findings of a left paraduodenal hernia and laparoscopic repair was undertaken. The small intestine was reduced successfully, and the hernia orifice was approximated with a continuous closure. He was discharged uneventfully 4 days after admission. The characteristic clinical and imaging findings of paraduodenal hernias are reviewed. Laparoscopic repair is reasonable in patients who have a paraduodenal hernia without intestinal ischemia.

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Laparoscopic repair of a left-sided paraduodenal hernia

Surgical Endoscopy ◽

10.1007/s00464-015-4648-1 ◽

2015 ◽

Vol 30 (8) ◽

pp. 3636-3637 ◽

Cited By ~ 3

Author(s):

Joshua S. Winder ◽

Eric M. Pauli ◽

Randy S. Haluck

Keyword(s):

Laparoscopic Repair ◽

Paraduodenal Hernia

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Rare cause of chronic abdominal pain: left paraduodenal hernia and its surgical management

BMJ Case Reports ◽

10.1136/bcr-2021-245024 ◽

2021 ◽

Vol 14 (12) ◽

pp. e245024

Author(s):

Ajay Chikara ◽

Sasidhar Reddy Karnati ◽

Kailash Chand Kurdia ◽

Yashwant Sakaray

Keyword(s):

Abdominal Pain ◽

Stable Condition ◽

Paraduodenal Hernia ◽

Inferior Mesenteric Vein ◽

Anterior Border ◽

Initial Reduction ◽

Contrast Enhanced ◽

History Of ◽

Enhanced Computed Tomography

A 30-year-old man presented with colicky abdominal pain for 2 months, associated with occasional episodes of bilious vomiting. He had a history of similar complaints at the age of 16 and 26 years. Contrast-enhanced computed tomography abdomen was consistent with a diagnosis of left paraduodenal hernia. On laparoscopy a 3 × 3 cm hernial defect was identified in the left paraduodenal fossa (fossa of Landzert). Contents were jejunal, and proximal ileal loops which were dilated and edematous. Anterior border of the sac was formed by the inferior mesenteric vein and left branch of the left colic artery. Initial reduction of contents was easy. However, complete reduction proved to be difficult due to adhesions with the sac opening, the hernial sac instead laid open by dividing the Inferior Mesentric Vein (IMV) (anterior border of defect) using a vascular stapler. The patient was discharged on postoperative day 3 in a stable condition. On follow-up the patient is doing well.

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An interesting case of left paraduodenal hernia.

The Professional Medical Journal ◽

10.29309/tpmj/2021.28.05.4648 ◽

2021 ◽

Vol 28 (05) ◽

pp. 755-758

Author(s):

Sahar Saeed ◽

Abeera Butt ◽

Syed Asghar Naqi ◽

Muhammad Mohsin Ali

Keyword(s):

Small Bowel ◽

Small Bowel Obstruction ◽

Bowel Obstruction ◽

Interesting Case ◽

Paraduodenal Hernia ◽

Absorbable Suture ◽

Internal Hernias ◽

Plain Abdominal Radiography ◽

History Of ◽

Operative Recovery

Paraduodenal fossa hernias (PDFHs) represent 53% of all congenital internal hernias and 0.2-0.9% of all small bowel obstructions. Most of these hernias are diagnosed incidentally on laparotomy, and carry up to 50% lifetime risk of development of small bowel obstruction. We present our experience in diagnosing and treating a case of a massive left paraduodenal fossa hernia in a 17 year male, containing over 30% of the small bowel (jejunum and ileum), presenting with a history of recurrent incomplete small bowel obstruction. Plain abdominal radiography showed distended loops of jejunum and few air fluid levels. After laparotomy and identification of hernia, small gut was reduced and examined, which was found to be structurally and functionally intact with normal vascularity. The defect was closed with continuous absorbable suture (Vicryl 2-0) sparing the inferior mesenteric vessels. Patient’s post-operative recovery remained uneventful and he was discharged on 4th post-operative day.

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