Left Paraduodenal Hernia: An Uncommon Cause of Acute Abdomen

Abstract

A 66-year-old woman visited the emergency department because of sudden onset of nausea, vomiting, and left hemi-abdominal pain that progressed to the upper hemi-abdomen 2 hours prior to her visit. A physical examination performed on admission revealed gradually exacerbating abdominal pain. Radiologic studies revealed a sac-like dilatation of the proximal jejunum with bezoar impaction in the left paraduodenal fossa. Emergent laparotomy was performed under the impression of left paraduodenal hernia, and an incarcerated jejunum with perforation was found in the left paraduodenal fossa. Paraduodenal hernia is a relatively rare cause of acute abdomen, and its diagnosis is often incorrect or delayed owing to its variable clinical manifestations. Therefore, it is important for clinicians to recognize this condition, diagnose it early, and avoid its misdiagnosis, owing to its high overall mortality rate.

Keywords

• hernia
• internal
• intestinal obstruction
• paraduodenal