Asian Journal of Case Reports in Surgery

A Case Report on Left Paraduodenal Internal Hernia with Congenital Ladd’s Bands

Sidharth Misra *

Terna Speciality Hospital & Research Centre, India and Armed Forces Medical College, India.

Sangram Karandiker

Terna Speciality Hospital & Research Centre, India.

*Author to whom correspondence should be addressed.

---

Abstract

A 34-year-old male presented to the emergency department with complaints of sudden onset abdominal pain associated with nausea. He had similar complaints 2 months back which resolved spontaneously. Abdominal examination revealed tenderness in the periumbilical and the right lumbar region. These features were suggestive of sub-acute intestinal obstruction. The patient was diagnosed to have left paraduodenal hernia on contrast enhanced computed tomography. Jejunum and ileal loops were noted to be in the hernial sac. Surgical repair involved adhesiolysis of the bowel loops, reduction of the hernial sac contents and closure of the hernial defect. The patient had no post operative complications.

Keywords: Internal hernia, paraduodenal hernia, bowel adhesions, intestinal obstruction

---

---

---

References

Ghahremani GG. Internal abdominal hernias. Surg Clin North Am. 1984 Apr;64(2):393-406. DOI: 10.1016/s0039-6109(16)43293-7.

Moshref LH, Alqahtani SH, Majeed ZA, Miro J. Left paraduodenal hernia: a rare cause of recurrent abdominal pain: case report. Pan Afr Med J. 2021;40:135. DOI: 10.11604/pamj.2021.40.135.32065.

Padhy BP. Congenital internal hernia a rare cause of acute intestinal obstruction. Indian J Surg. 2013;75(2):156-8. DOI: 10.1007/s12262-012-0506-8.

Kumar A, Ramakrishnan TS, Behl A, Sahu S, Singh G. Intestinal obstruction in a child: internal hernia caused by an anomalous congenital band. Trop Gastroenterol. 2010; 31(3):219-21.

Martin LC, Merkle EM, Thompson WM. Review of internal hernias: radiographic and clinical findings. AJR Am J Roentgenol. 2006 Mar;186(3):703-17. DOI: 10.2214/AJR.05.0644.

Fan HP, Yang AD, Chang YJ, Juan CW, Wu HP. Clinical spectrum of internal hernia: a surgical emergency. Surg Today. 2008;38(10):899-904. DOI: 10.1007/s00595-007-3756-5.

Takeyama N, Gokan T, Ohgiya Y, Satoh S, Hashizume T, Hataya K et al. CT of internal hernias. Radiographics. 2005; 25(4):997-1015. DOI: 10.1148/rg.254045035.

Blachar A, Federle MP. Internal hernia: an increasingly common cause of small bowel obstruction. Semin Ultrasound CT MR. 2002 (2):174-83. DOI: 10.1016/s0887-2171(02)90003-x.

Jain SK, Kaza RC, Garg PK. Incidental congenital transmesenteric hernia in an adult. Eur Rev Med Pharmacol Sci. 2011;15(4):461-2.

Blachar A, Federle MP, Dodson SF. Internal hernia: clinical and imaging findings in 17 patients with emphasis on CT criteria. Radiology. 2001;218(1):68-74. DOI:10.1148/radiology.218.1.r01ja5368

Xu H, Nie N, Kong F, Zhong B. Large left paraduodenal hernia with intestinal ischemia: a case report and literature review. J Int Med Res. 2020;48(9): 300060520955040. DOI: 10.1177/0300060520955040.

Okino Y, Kiyosue H, Mori H, Komatsu E, Matsumoto S, Yamada Y et al. Root of the small-bowel mesentery: correlative anatomy and CT features of pathologic conditions. Radiographics. 2001;21(6): 1475-90. DOI:10.1148/radiographics.21.6.g01nv121475

Lanzetta MM, Masserelli A, Addeo G, Cozzi D, Maggialetti N, Danti G et al. Internal hernias: a difficult diagnostic challenge. Review of CT signs and clinical findings. Acta Biomed. 2019;90(5-S):20-37. DOI: 10.23750/abm.v90i5-S.8344.

Assenza M, Rossi D, Rossi G, Reale C, Simonelli L, Romeo V et al. Laparoscopic management of left paraduodenal hernia. Case report and review of literature. G Chir. 2014;35(7-8):185-9.

Titan AL, Garagliano JM, Spain D. Management of an internal hernia through the foramen of Winslow. Trauma Surg Acute Care Open. 2022;7(1):e000960. DOI: 10.1136/tsaco-2022-000960.

Facchiano E, Soricelli E, Lucchese M. Laparoscopic Management of Internal Hernia After One Anastomosis Gastric Bypass (OAGB). Obes Surg. 2020;30(10): 4169-4170. DOI: 10.1007/s11695-020-04791-y.

Jatal SN, Jatal S, Ingle S. Transmesenteric Internal Hernia Presenting with Strangulation of Bowel in Adult- A Case Report. Asian J. Res. Surg. [Internet]. 2023 Sep. 18 [cited 2024 May 16];6(2):240-4. Available:https://journalajrs.com/index.php/AJRS/article/view/161

Messaoudi IE, Laalou A, Aragon O, Chtaibi K, Njoumi N, Ali AA. Left Paraduodenal hernia: Rare cause of acute intestinal obstruction. Asian J. Case Rep. Surg. [Internet]. 2024 Jan. 17 [cited 2024 May 16];7(1):13-6. Available:https://journalajcrs.com/index.php/AJCRS/article/view/490

Al Laham O, Albrijawy R, Ahmad I, Atia F, Shaheen J, Aldeen BA. A distinctive case of congenital midgut malrotation with volvulus in an adolescent female managed by Ladd's procedure-A case report. International Journal of Surgery Case Reports. 2022 Jan 1;90: 106752.