An uncommon cause of acute bowel obstruction: the left para-duodenal hernia

Abstract

Internal hernias of the abdomen are uncommun. They represent less than 1% of bowel obstruction cases. The left paraduodenal hernia is the most frequent type of internal hernias. We report a case of 77 year-old woman consulting for bowel obstruction evolving since two days. The abdominal computed tomography revealed a retroperitoneal small bowel contained in a peritoneal sac. The surgical exploration confirmed the diagnosis of a left internal paraduodenal hernia by showing incarcerated jejunal loops in a paraduodenal hernia through a narrow opening to the left of the angle of Treitz. A surgical reduction of the hernia and closure of the hernia neck were performed. The follow-ups were uncomplicated. Through this observation and a literature review, we try to recall the clinical and radiological characteristics of this disease and to clarify the therapeutic modalities.