Internal hernias are the causes of 0.5 to 5.8 per cent of all cases of small bowel obstruction. Left paraduodenal hernia (PDH) is the most common congenital internal hernia encountered in adults. The symptoms and physical findings associated with PDH are vague and nonspecific before the onset of complicated intestinal obstruction. Diagnoses are most commonly established by CT. This case presentation and review is intended to promote clinicians’ awareness of this unusual but potentially highly morbid condition, discuss CT findings associated with PDH, and illustrate the importance of timing in the acquisition of diagnostic abdominal CT scans.
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References
1.
BlacharA., FederleM.P., DodsonS.F.Internal hernia: clinical and imaging findings in 17 patients with emphasis on CT criteria.Radiol2001; 218: 68–74.
2.
PeltierJ., Le GarsD., PageC.The duodenal fossae: anatomic study and clinical correlations.Surg Radiol Anat2005; 27: 303–7.
3.
MillerP.A., MezwaD.G., FeezkoP.J.Imaging of abdominal hernias.Radiographics1995; 15: 333–47.
4.
PalaniveluC., RangarajanM., JategaonkarP.A.Laparoscopic management of paraduodenal hernias: mesh and mesh-less repairs. A report of four cases.Hernia2008; 12: 649–53.
5.
SuchatoC., PekananP., PanjapiyakulC.CT findings in symptomatic left paraduodenal hernia.Abdom Imaging1996; 21: 148–9.
6.
MartinL.C., MerkleE.M., ThompsonW.M.Review of internal hernias: radiographic and clinical findings.AJR Am J Roentgenol2006; 186: 703–17.
ZissinR., HertzM., GayerG.Congenital internal hernia as a cause of small bowel obstruction: CT findings in 11 adult patients.Br J Radiol2005; 78: 796–802.
9.
SchafflerG.J., GroellR., KammerhuberF.Anterior and upward displacement of the inferior mesenteric vein: a new diagnostic clue to left paraduodenal hernias?Abdom Imaging1999; 24: 29–31.
10.
GhiassiS., NguyenS.Q., DivinoC.M.Internal hernias: clinical findings, management, and outcome in 49 nonbariatric cases.J Gastrointest Surg2007; 11: 291–5.
11.
YooH.Y., MergelasJ., SeibertD.G.Paraduodenal hernia. A treatable cause of upper gastrointestinal tract symptoms.J Clin Gastroenterol2000; 3: 226–9.
12.
NewsomB.D., KukoraJ.S.Congenital and acquired internal hernias: unusual causes of small bowel obstruction.Am J Surg1986; 152: 279–84.
13.
BlacharA., FederleM.P.Internal hernia: an increasingly common cause of small bowel obstruction.Semin Ultrasound CT MR2002; 23: 174–83.
14.
ErD., RuizO.R., KennedyG.M.Paraduodenal hernia: a report of two cases.Am Surg2001; 67: 733–6.
15.
OvaliG.Y., OrgucS., UnluM., PabuscuY.Transient left paraduodenal hernia.Comput Med Imaging Graph2005; 29: 459–61.
16.
OsadchyA., WeisenbergN., WienerY.Small bowel obstruction related to left-sided paraduodenal hernia: CT findings.Abdom Imaging2005; 30: 53–5.
