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Central European Journal of Medicine

, Volume 8, Issue 1, pp 99–102 | Cite as

A case of a paraduodenal hernia with a concomitant mesosigmoid defect

  • Diego Milani
  • Alessia Corsi
  • Roberto Cirocchi
  • Alberto Santoro
  • Giorgio Di Rocco
  • Claudio Renzi
  • Giovanni Cochetti
  • Carlo Boselli
  • Giuseppe Noya
Case Report
  • 62 Downloads

Abstract

Introduction

Intestinal obstruction by congenital internal hernia is rare and unsuspected.

Case report

We report the case of a 45 years-old-man diagnosed to have an intestinal obstruction caused by a double concomitant internal hernia. CT scan can provide a fast diagnosis in order not to delay the surgical intervention: the ileum had been entrapped into a big internal hernia between the transverse and the descending colon and the patient was diagnosed to have a paraduodenal hernia. During the intervention a concomitant mesosigmoid defect was found.

Results

Our patient had a left paraduodenal hernia with much of the small bowel crowned into a round peritoneal membrane just in front and left to the duodenum and pancreas and between the transverse and descending colon. CT scan showed encapsulated cluster of small bowel loops in the hernia sac. He was taken up for surgery and an urgent laparoscopic access was performed for definitive diagnosis and treatment 4 days after the beginning of the symptoms.

Conclusions

Congenital Internal Hernia should be considered as a cause of bowel obstruction in absence of previous abdominal surgery and, even if preoperative diagnosis of a paraduodenal hernia is difficult, it must be considered as part of differential diagnosis.

Keywords

Paraduodenal hernia Urgent laparoscopy Mesosigmoid defect 

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Copyright information

© Versita Warsaw and Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Diego Milani
    • 1
  • Alessia Corsi
    • 1
  • Roberto Cirocchi
    • 1
  • Alberto Santoro
    • 2
  • Giorgio Di Rocco
    • 2
  • Claudio Renzi
    • 1
  • Giovanni Cochetti
    • 1
  • Carlo Boselli
    • 3
  • Giuseppe Noya
    • 3
  1. 1.Department of General SurgeryUniversity of PerugiaTerniItaly
  2. 2.Department of Surgical SciencesSapienza University of RomeRomeItaly
  3. 3.Department of General and Oncologic SurgeryUniversity of PerugiaPerugiaItaly

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