MANAGEMENT OF ACUTE PRESENTATION OF LEFT PARADUODENAL HERNIA WITH SPONTANEOUS REDUCTION Article Swipe
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· 2024
· Open Access
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· DOI: https://doi.org/10.1093/bjs/znae122.274
· OA: W4399048315
Background Left paraduodenal hernia is an internal hernia developed due to the prolapsed small bowel through the fossa of Landzert and is usually presented as acute abdomen or bowel obstruction. This abstract is about a case report of a patient with signs of strangulated left paraduodenal hernia. Methods A 32-year-old female presented with acute reccurent abdominal pain. Investigations with an enhanced CT scan showed crowding of small bowel loops in the left paraduodenal area, twisting of mesenteric vessels and mild dilatation of small bowel loops, signs suggesting possible internal herniation. Results The CT scan is showing the initial presentation with signs of internal herniation and the subsequent MRI shows spontaneous resolution. Due to mild symptoms of the patient we proceeded to an exploratory laparoscopy to exclude sings of intestinal ischemia. Exploratory laparoscopy did not reveal any signs of ischemia and confirmed the prevalence of the fossa of Landzert, that was managed by widening the orifice of the herniation site. Conclusions Strangulation and incarceration can occur in up to 64% in paraduodenal hernia, so exploratory laparoscopy could be an adjunctive tool in excluding intestinal ischemia, verifying the site of herniation even in cases of spontaneous reduction and repairing the orifice to prevent recurrence.
