1997 Volume 58 Issue 7 Pages 1519-1522
We experienced a case of right paraduodenal hernia causing strangulation of the small intestine. A 18-year-old female was seen at the hospital because of severe abdominal pain. She had a tender, fist-sized tumor at the right mid-abdomen. Abdominal computed tomography (CT) demonstrated clustering loops of the small intestine along with thickened mesenterium and mesenteric vessels in linear structure. These findings suggested the existence of strangulation of the small intestine. At laparotomy, it was found that the small bowel was impacted into the right side of the retroperitoneal space through an opening of the right paraduodenal portion, the finding being consistent with right paraduodenal hernia. The incarcerated bowel was repositioned and the opening was closed. Paraduodenal hernia is one of the internal abdominal hernias which is seldom encountered in daily practice. Therefore, an intestinal obstruction secondary to internal hernias can be hardly diagnosed preoperatively. However, the cystic accumulation of the small intestine on CT images is characteristic of this pathology, and may be great help in the preoperative diagnosis as was the present case. It is advised that paraduodenal hernia should be taken into account in the diagnosis of the intestinal obstruction, particularly, in patients without any history of laparotomy.
