Aunt Minnie's corner. Left paraduodenal internal hernia

A rare case of acute abdomen due to strangulated Waldayer's hernia

INTRODUCTION

An internal hernia is the herniation of an intestinal segment into an intra-peritoneal fossa, is an uncommon cause for intestinal obstruction and is difficult to diagnose preoperatively.

PRESENTATION OF CASE

We report a male patient 19 years old presenting with acute abdomen due to a strangulated Waldayer's hernia.

DISCUSSION

The paraduodenal hernias are more common in males (M:F ratio 3:1). The average age at diagnosis is 38.5 years clinically presenting with chronic intermittent post-parandial abdominal pain. An accurate incidence of paraduodenal hernias in infancy and childhood is unknown, but is quite rare.

CONCLUSION

Internal complicated hernias are difficult to diagnose and once discovered intra-operative anatomical variations are present with special attribution to the management of the hernia sac.

Current Diagnostic Role of CT in Evaluating Internal Hernia

Transmesenteric hernia is frequently encountered in practice, and because of the high risk of strangulation, even small internal hernias are dangerous. Knowledge of the characteristic imaging features and the mechanism of internal hernia can lead to early detection and correct diagnosis, both of which can save the patient's life. This article describes common CT findings of internal hernia with emphasis on various postoperative transmesenteric hernias as well as other common internal hernias.

Bilateral Diaphragmatic Agenesis in an Adult Complicated by a Paraduodenal Hernia

Diaphragmatic agenesis is an extremely rare clinical entity and has only been reported five previous times in the English literature. We report a patient with bilateral diaphragmatic agenesis complicated by a paraduodenal hernia. Diaphragmatic agenesis is rarely diagnosed preoperatively. Most diagnoses will likely be made during exploration for suspected bowel obstruction or other gastrointestinal emergency. When they are found repair seems warranted if contamination from associated procedures such as bowel resection is minimal. Repair of diaphragmatic agenesis can be approached much like the creation of a neodiaphragm after diaphragmatic resection. The diagnosis of paraduodenal hernia can usually be confirmed radiologically. Many cases of paraduodenal hernias have been reported and repair is uniformly recommended.