2019 Volume 39 Issue 5 Pages 891-895
A 34-year-old male was admitted to our hospital with sudden left side upper abdominal pain one hour after symptom onset. An enhanced abdominal CT scan showed regional dilation of the intestine at the left upper abdomen and a stretched inferior mesenteric vein located at the ventral edge of dilated intestinal loops. Poor enhancement of the intestinal wall was also seen. Emergency laparoscopic surgery was performed with a diagnosis of a strangulation ileus caused by a left paraduodenal hernia. Laparoscopic findings showed that the hernia orifice existed in the left side of Treitz’s ligament and about 50 cm of the proximal jejunum had intruded into the mesenteric defect. Reduction of the small intestine could be performed without necrosis or irreversible ischemia and we sutured the hernia orifice closed. The postoperative course was good and the patient was discharged from the hospital on the fourth day. In past reports, abdominal enhanced CT is useful for early diagnosis of a left paraduodenal hernia because of its characteristic findings. This disease has a lower risk of intestinal resection due to necrosis. Laparoscopic surgery is an efficient surgical treatment for this disease.
