A rare pathology that caused high-level intestinal obstruction: left paraduodenal hernia

The aim of this report is to assess clinical findings and surgical treatment of left paraduodenal hernia, which is an
unusual type of internal herniation, in light of the literature. The diagnosis and treatment course of a 42-year-old
male patient with findings of intestinal obstruction was assessed and presented together with literature search. The
patient underwent surgery with a preliminary diagnosis of intestinal obstruction and the definitive diagnosis of
internal herniation was made intraoperatively. Nearly two-thirds of the small intestine was found to be herniated
into the retroperitoneal space from the left paraduodenal region. Small bowel loops were pulled out of the hernia
sac and anatomically positioned in the intraperitoneal area. The hernia sac was repaired primarily. The patient was
discharged on the fourth postoperative day, uneventfully. Left paraduodenal hernia should be considered as a part
of differential diagnosis in patients who have recurring abdominal pain episodes accompanied by symptoms suggestive of intestinal obstruction. Timely diagnosis is important to prevent complications. Reduction of hernia content
followed by primary repair of the defect appears to be a safe and effective treatment.
Key Words: Paraduodenal hernia, internal hernia, intestinal obstruction