Laparoscopic treatment of acute small bowel obstruction due to left paraduodenal hernia: A case report and literature review

Maurizio Zizzo, Nazareno Smerieri, Italo Marco Barbieri, Andrea Lanaia, Stefano Bonilauri

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Introduction Internal hernia is a pathological condition resulting from abnormal protrusion of abdominal viscera through an opening in the intraperitoneal recesses of the abdominal cavity. Small bowel obstruction due to internal hernia is not common (0.25-0.9% of cases). The most common group is that of paraduodenal hernias (53%), of which the left-sided one is the most common type (75%). Presentation of case We report a case of a 43 year-old man with a history of recurrent abdominal pain, who was hospitalized because of an episode of acute small bowel obstruction. He had no previous surgery. Computed tomography revealed an encapsulated circumscribed cluster of jejunal loops in the left upper quadrant, near the ligament of Treitz, and the hernia orifice was adjacent to the left side of the inferior mesenteric vessels. Emergency laparoscopic surgery was performed: the small bowel was found completely herniated under the inferior mesenteric vessels. It was gradually reduced and the hernia space was closed with a running suture. The patient was discharged on the fourth day without complications. Conclusion Left paraduodenal hernia is a rare cause of small bowel obstruction that should be taken into account in a patient with a history of recurrent abdominal pain or intestinal obstruction, and no previous surgery. Computed tomography is the standard for a correct diagnosis. Surgery is treatment of choice, because it reduces the risk of emergency and complications associated to hernia. Laparoscopic approach is feasible and effective, also in emergency situation.

Original languageEnglish
Pages (from-to)87-91
Number of pages5
JournalInternational Journal of Surgery Case Reports
Volume20
DOIs
Publication statusPublished - 2016
Externally publishedYes

Fingerprint

Hernia
Emergencies
Abdominal Pain
Therapeutics
Tomography
Viscera
Abdominal Cavity
Intestinal Obstruction
Ligaments
Laparoscopy
Sutures

Keywords

  • Laparoscopic treatment
  • Left paraduodenal hernia
  • Small bowel obstruction

ASJC Scopus subject areas

  • Surgery

Cite this

Laparoscopic treatment of acute small bowel obstruction due to left paraduodenal hernia : A case report and literature review. / Zizzo, Maurizio; Smerieri, Nazareno; Barbieri, Italo Marco; Lanaia, Andrea; Bonilauri, Stefano.

In: International Journal of Surgery Case Reports, Vol. 20, 2016, p. 87-91.

Research output: Contribution to journalArticle

Zizzo, Maurizio ; Smerieri, Nazareno ; Barbieri, Italo Marco ; Lanaia, Andrea ; Bonilauri, Stefano. / Laparoscopic treatment of acute small bowel obstruction due to left paraduodenal hernia : A case report and literature review. In: International Journal of Surgery Case Reports. 2016 ; Vol. 20. pp. 87-91.
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abstract = "Introduction Internal hernia is a pathological condition resulting from abnormal protrusion of abdominal viscera through an opening in the intraperitoneal recesses of the abdominal cavity. Small bowel obstruction due to internal hernia is not common (0.25-0.9{\%} of cases). The most common group is that of paraduodenal hernias (53{\%}), of which the left-sided one is the most common type (75{\%}). Presentation of case We report a case of a 43 year-old man with a history of recurrent abdominal pain, who was hospitalized because of an episode of acute small bowel obstruction. He had no previous surgery. Computed tomography revealed an encapsulated circumscribed cluster of jejunal loops in the left upper quadrant, near the ligament of Treitz, and the hernia orifice was adjacent to the left side of the inferior mesenteric vessels. Emergency laparoscopic surgery was performed: the small bowel was found completely herniated under the inferior mesenteric vessels. It was gradually reduced and the hernia space was closed with a running suture. The patient was discharged on the fourth day without complications. Conclusion Left paraduodenal hernia is a rare cause of small bowel obstruction that should be taken into account in a patient with a history of recurrent abdominal pain or intestinal obstruction, and no previous surgery. Computed tomography is the standard for a correct diagnosis. Surgery is treatment of choice, because it reduces the risk of emergency and complications associated to hernia. Laparoscopic approach is feasible and effective, also in emergency situation.",
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