Left Paraduodenal Hernia: A Tricky Situation

Abstract

Paraduodenal hernias are important cause of internal hernia. Left paraduodenal hernia occurs through paraduodenal fossa of Landzert. Paraduodenal hernia occur due to errors of midgut rotation during embryological development. Most of the patients present in emergency with acute or subacute intestinal obstruction. X-ray shows air fluid levels which maintains their position with change of position. CT of abdomen is more reliable investigation for diagnosis. For left sided paraduodenal hernia, neck of the sac should be divided caudally, or can be divided cranially to avoid injury to the vessels. Sound embryological knowledge about the condition will ease the surgical management. Elective laparoscopic surgery can be considered for non obstructive left paraduodenal hernia.

Keywords

• fossa of landzert
• intestinal obstruction
• midgut rotation