Case Report on Paraduodenal Hernia: An Uncommon Cause of a Common Surgical Problem

The most typical kind of internal hernia is the paraduodenal hernia. The majority of patients who seek emergency care have a recent history of abdominal pain and occasional episodes of nausea and vomiting. Occlusion of the closed loop can lead to ischemia of the herniated bowel loop. Paraduodenal hernia is a rare congenital anomaly arising from an error of rotation of the midgut.A 32 years old male patient who presented with complaints of pain abdomen, breathlessness and multiple episodes of vomiting for a day.

He underwent emergency exploratory laparotomy with excision of the hernial sac, bowel resection with duodeno-ileal anastomosis and was discharged on post op day 5 on a liquid diet.

The acquired internal hernias are most commonly seen following rearrangement of the intra-abdominal structures following surgeries like, bowel resection and anastomosis, hepaticojejunostomy or most notably after Roux-en-Y gastric bypass. An early diagnosis with appropriate imaging techniques, X-ray or CT scan of the abdomen is essential to reduce the associated morbidity. Early surgical intervention is the deciding factor in the associated mortality in these patients. Surgery should be performed with the goal of reducing the contents, whether or not the hernia wall or sac is removed. The defect should then be simply closed with non-absorbable interrupted sutures, avoiding the vessels that make up the hernia's walls.