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Case Studies | General Surgery | India | Volume 14 Issue 3, March 2025 | Popularity: 5 / 10
Para-Duodenal Hernias: Early and Late Presentations
Dr. C Priyadarshini
Abstract: Background: Internal hernias, defined as a protrusion of viscus through an intraabdominal aperture without traversing fascial planes, cause 0.6% to 5.8% of small bowel obstructions. Para duodenal hernias comprise 50% of all congenital internal hernias. They are more common in men at a 3:1 ratio, and despite their congenital nature, they most commonly present in the third or fourth decades of life. They are either left (75%) or right sided (25%), and distinct in their pathogenesis. Case report: Two patients with variable presentation of paraduodenal hernias are encountered. A 49 year old male patient with vague abdominal pain for 1 day in the left upper quadrant of abdomen. CT images showed features suggestive of left paraduodenal hernia with features suggestive of small bowel obstruction. A 24 year old male patient with severe abdominal pain and persistent vomiting for 2 days with diffuse tenderness and guarding. CT images showed features of strangulated left paraduodenal hernia. Emergency laparotomy was done in both cases. Reduction of the contents and Hernial orifice closure was done in the first patient. Resection of gangrenous small bowel and Double barrel ostomy was done in the latter patient. Conclusion: Due to the rarity and their varying presentations, morbidity and mortality rates vary greatly. Knowing congenital forms of internal hernia is important in recognizing acutely life-threatening obstructions or diagnosing the etiology of chronic abdominal pain. Timing of presentation and Early use of CT imaging and early intervention decides the prognosis and outcome of the patients.
Keywords: Internal hernia, Paraduodenal hernia, Intestinal obstruction, Abdominal pain, CT imaging, Laparotomy, Ostomy
Edition: Volume 14 Issue 3, March 2025
Pages: 1482 - 1485
DOI: https://www.doi.org/10.21275/MR25326181345
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