Abstract
A 96-year-old woman admitted for right abdominal pain was diagnosed with intestinal obstruction.
Physical examination showed a mass in the right abdomen, and an abdominal computed tomography (CT) scan showed dilatation of the small intestine around the cecum.
The patient underwent long-tube decompression and received conservative medical management.
However, the symptoms did not improve, and surgery was perfomed 6 days after admission.
Because she had not undergone laparotomy, surgery was performed under suspicion of internal hernia.
Strangulation of the small intestine because of paracecal hernia in the superior ileocecal recess was detected during the operation.
After reducing the length of the impacted small intestine and closing the hernial opening, partial resection of the recovered ischemic intestine was performed.
Paracecal hernia is a rare condition and its preoperative diagnosis is usually difficult ; however, it should be included in the differential diagnosis of ileus when dilatation as the small intestine around the cecum is detected. Because paracecal hernia frequently causes strangulated ileus, it is important that operation should be perfomed at an appropriate time.
