Obstructed giant right paraduodenal hernia presenting as an abdominal mass

Sanoop Koshy Zachariah, Sridevi Rajeeve


Internal hernias are rare cases of small intestinal obstruction of which Right Paraduodenal hernias through the Fossa of Waldeyer occur only in less than a quarter of all cases. A high index of suspicion and a good understanding about the pathological anatomy is pertinent for the detection and successful management of this condition which has non-specific symptomatology. The gold standard of diagnosis is computed tomography scan, which shows characteristic findings. Surgical correction is often necessary as mortality rates hover above 50% in unintervened cases. Here we present very rare case of an obstructed right paraduodenal hernia which presented as an abdominal mass.


Congenital hernia, Intestinal obstruction, Internal hernia, Right paraduodenal hernia

Full Text:



Freund H, Berlatzky Y. Small paraduodenal hernias. Archives of Surg. 1977;112:1180-3.

Newsom BD, Kukora JS. Congenital and acquired internal hernias: unusual causes of small bowel obstruction. Am J Surg. 1986;152:279-85.

Bartlett MK, Wang C, Williams WH. The surgical management of paraduodenal hernia. Ann Surg. 1968;168:249-54.

Gruff D, Malrotation. In: Ashcarft KW, Holder TM, editors. Paediatric Surgery. 2nd Edition. Philadelphia: W.B. Saunder's Company; 1993:320-330.

Brigham RA, Fallon WF, Saunders JR, Harmon JW, d’Avis JC. Paraduodenal hernia: diagnosis and surgical management. Surgery. 1984;96:498-502.

Desjardins AU. Left paraduodenal hernia. Ann Surg. 1918;67:195-201.

Zimmerman LM, Laufman H. Intraabdominal hernias due to developmental and rotational anomalies. Ann Surg. 1953;138:82-91.

Ghahremani GG. Internal abdominal hernias. Surg Clin North Am. 1984;64:393–406

Cogswell HD, Thomas CA. Right paraduodenal hernia. Ann Surg. 1941;114:1035-41.

Mathur V, Parakh P, Tiwari M, Bhandari A, Pareek P, Chaturvedi H. Ind J Radiol Imag. 2006;16:3:371-2.

Khan MA, Lo AY, Vande Maele DM. Paraduodenal hernia. Am Surg. 1998;64:1218-22.