DOI: http://dx.doi.org/10.18203/2349-2902.isj20203498

Laparoscopic management of a small bowel obstruction: paraduodenal hernia

Shrenik Govindaraj, Sridar Govindaraj, Mario Victor Newton, Clement Prakash

Abstract


Paraduodenal hernia are very rare but the commonest internal hernia. Left paraduodenal hernia is due to herniation of the small bowel into the fossa of Landzert. The fossa results from a combination of failure of fusion of the small bowel mesentery with the retro peritoneum and malrotation of the midgut. Here we present a 27 years lady who saw multiple consultants with varied presentations and underwent extensive investigations over a one-year period, with one consultant referring her to a psychiatrist for malingering. CT scan revealed a foramen of Winslow hernia. The radiologist has to be aware of the CT findings of this unusual hernia. At laparoscopy, it was a left paraduodenal containing small bowel. We reduced the contents and plicated the sac with closure of the mouth. Patient did well and was discharged on 3rd post-operative day. On follow up she is doing well.


Keywords


Paraduodenal hernia, Fossa of Landzert, Laparoscopy, Internal hernia

Full Text:

PDF

References


Khan MA, Lo AY, Maele VDM. Para-duodenal hernia. Am J Surg. 1998;64:1218-22.

Tong RS, Sengupta S, Tjandra JJ. Left paraduodenal hernia: case report and review of the literature. ANZ J Surg. 2002;72:69-71.

Liew KL, Choong CS, Shiau GF. Descending mesocolon defect herniation: case report. Changgeng Yi Xue Za Zhi. 1999;22:133-7.

Manji R, Warnock GL. Left paraduodenal hernia: an unusual cause of small bowel obstruction. Can J Surg. 2001;44:455-7.

Zonca P, Maly T, Mole DJ. Treitz’s hernia. Hernia. 2008;12:531-34.

Brigham RA. Paraduodenal hernia. In: Nyhus LM, Condon RE. (ed.) Hernia. 4th ed Philadelphia: Lippincott Williams and Wilkins; 1995.

Moynihan GBA. On retroperitoneal hernia. New York: William Wood and Co; 1906.

Andrews E. Duodenal Hernia: a misnomer. Surg Gynecol Obstet. 1923;37:740.

AJR entitled Review of Internal Hernias: Radiographic and Clinical Findings. Available at https://www.ajronline.org/doi/10.2214/AJR.05.064.

Ghahremani GG. Abdominal and pelvic hernias. In: Gore RM, Levine MS, eds. Textbook of gastrointestinal radiology, 2nd ed. Philadelphia, PA: Saunders; 2000: 1993-2009.

Mostafa D, Feky E, Morgan MA. Radiopaedia. Available at: https://radiopaedia.org. Accessed on 3 March 2020.

Dyananda L, Sreekumar KP, Moorthy S, Prabhu NK. Para-duoenal hernias: a pictorial essay. Indian J Radiol Imaging. 2006;16:469-71.

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

Masaki F, Akio K. Laparoscopic Surgery of Left Paraduodenal Hernia. J Laparoendosc Adv Surg Tech. 2004;14:111-5.

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