Laparoscopic repair of a left paraduodenal hernia

Abstract

Paraduodenal hernias are the most common internal hernias. Their diagnosis is usually made after complication as strangulation or intestinal obstruction. Diagnosis is easily made with abdominal CT scan. 45 years-old woman with no medical history was presented to the emergency department of our hospital with two-days of abdominal pain particularly in the left upper hemi-abdomen. The pain was associated with nausea and bilious vomiting. Abdominal examination revealed an abdominal distension with left upper quadrant tenderness. A CT scan of the abdomen was performed which demonstrated the same encapsulated cluster of jejunal loops having a radial arrangement located in the omental bursa. Their meso and vessels converged towards the transverse mesocolon and pushing back the stomach towards and the pancreas backwards with a distension of the duodenum upstream. Patient underwent emergency laparoscopic surgery under general anaesthesia with the patient placed in supine split-leg position. The patient was discharged on postoperative day second.