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Khedr S, Abdelmohsen SM, Abdelazim O. Mesocolic hernia, a case series. Int J Surg Case Rep 2024; 119:109696. [PMID: 38714067 PMCID: PMC11098949 DOI: 10.1016/j.ijscr.2024.109696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 04/18/2024] [Accepted: 04/19/2024] [Indexed: 05/09/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE Paraduodenal hernias are difficult to diagnose due to their unusual presentation. Herein, five new cases are added to the literature. CASE PRESENTATION Four male and one female child complained of paraduodenal hernias, two on the right side and three on the left side. The intestinal part that herniated inside the hernia sac was also malrotated in four patients. One patient had Meckel's diverticulum with a herniated intestine. One infant had extrahepatic biliary disease, a single atrium, polysplenia, intestinal malrotation, and a left paraduodenal hernia. Exploratory labarotomy was done for reduction of the intestine, reorientation, and repair of hernia orifices. CLINICAL DISCUSSION Paraduodenal hernia is a component of malrotation. Cautious dissection of the hernia orifice is required to keep away from injuries to the inferior mesenteric vein or left colic artery in the course of the restoration of the left paraduodenal hernia. Also, the superior mesenteric vessels may be injured in the course of the restoration of the right paraduodenal hernia. CONCLUSION There is a correlation between the occurrence of PDH with malrotation. The diagnosis of malrotation can be made with an ultrasound abdomen; however, it is true that ultrasound cannot make a confirmed diagnosis in all patients. Once the diagnosis of a mesocolic hernia has occurred, surgical repair is mandatory by closure of the defect.
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Affiliation(s)
- Sayed Khedr
- Lecturer of Pediatric Surgery at Cairo University Children Hospital, Cairo University, Egypt
| | | | - Osama Abdelazim
- Lecturer of Pediatric Surgery at Cairo University Children Hospital, Cairo University, Egypt
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Concomitant ileocecal intussusception due to cecal lipoma and paraduodenal hernia. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2022. [DOI: 10.1016/j.epsc.2022.102186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Ikoma S, Yano K, Harumatsu T, Muto M, Ieiri S. Left paraduodenal hernia with intestinal volvulus mimicking midgut volvulus. Pediatr Int 2022; 64:e14964. [PMID: 35112444 DOI: 10.1111/ped.14964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 07/22/2021] [Accepted: 08/17/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Shinichiro Ikoma
- Department of Pediatric Surgery, Research Field in Medicine and Health Sciences, Medical and Dental Sciences Area, Research and Education Assembly, Kagoshima University, Kagoshima, Japan
| | - Keisuke Yano
- Department of Pediatric Surgery, Research Field in Medicine and Health Sciences, Medical and Dental Sciences Area, Research and Education Assembly, Kagoshima University, Kagoshima, Japan
| | - Toshio Harumatsu
- Department of Pediatric Surgery, Research Field in Medicine and Health Sciences, Medical and Dental Sciences Area, Research and Education Assembly, Kagoshima University, Kagoshima, Japan
| | - Mitsuru Muto
- Department of Pediatric Surgery, Research Field in Medicine and Health Sciences, Medical and Dental Sciences Area, Research and Education Assembly, Kagoshima University, Kagoshima, Japan
| | - Satoshi Ieiri
- Department of Pediatric Surgery, Research Field in Medicine and Health Sciences, Medical and Dental Sciences Area, Research and Education Assembly, Kagoshima University, Kagoshima, Japan
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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 2021; 48:300060520955040. [PMID: 32938278 PMCID: PMC7503021 DOI: 10.1177/0300060520955040] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
A left paraduodenal hernia is a rare type of internal hernia but the most common type of peritoneal recess hernia. Preoperative diagnosis of a left paraduodenal hernia is difficult because of its nonspecific clinical manifestations, and it is often confused with other causes of acute abdomen. Diagnosis is therefore often delayed, resulting in serious clinical outcomes. We herein report a case of a large paraduodenal hernia with small intestinal obstruction and ischemia without abdominal pain. The patient was successfully discharged after emergency hernia repair. This case reveals the importance of diagnosing a left paraduodenal hernia with or without abdominal pain, especially in patients with no history of abdominal surgery.
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Affiliation(s)
- Hao Xu
- Department of Gastrointestinal Surgery, The First Hospital of China Medical University, Shenyang, China
| | - Ning Nie
- Comprehensive Geriatric First Ward, Jinqiu Hospital in Liaoning Province, Shenyang, China
| | - Fanmin Kong
- Department of Gastrointestinal Surgery, The First Hospital of China Medical University, Shenyang, China
| | - Banghua Zhong
- Department of Gastrointestinal Surgery, The First Hospital of China Medical University, Shenyang, China
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Udo IA, Obong V. Left Paraduodenal Hernia: A Cause of Double Intestinal Obstruction. Niger J Surg 2021; 27:78-80. [PMID: 34012249 PMCID: PMC8112357 DOI: 10.4103/njs.njs_43_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 05/18/2020] [Accepted: 06/05/2020] [Indexed: 11/16/2022] Open
Abstract
Paraduodenal hernias are of congenital origin and may present with symptoms and signs of small intestinal obstruction. These hernias are rare in our practice, and a definitive preoperative diagnosis is often not made as the symptoms are not specific. Early assessment and prompt and adequate resuscitation and surgery obviate the risk of strangulation and intestinal resection. This report highlights a rare cause of intestinal obstruction in a young male who presents with all the classical features of obstruction: colicky abdominal pain, distension, vomiting, and inability to pass stool or flatus. The diagnosis of paraduodenal hernia was made intraoperatively. We do not routinely request for barium examination or abdominal computed tomography scan in acute abdominal pain. These modalities can suggest a preoperative diagnosis.
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Affiliation(s)
- Isaac Assam Udo
- Department of Surgery, University of Uyo Teaching Hospital, Uyo, Nigeria
| | - Victor Obong
- Department of Surgery, University of Uyo Teaching Hospital, Uyo, Nigeria
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Treitz Hernia: Report of a Case and Review of the Literature. Surg Laparosc Endosc Percutan Tech 2019; 29:e102-e107. [PMID: 31385923 DOI: 10.1097/sle.0000000000000704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Congenital hernias are rare findings, and their diagnosis is often delayed due to an incorrect interpretation of the clinical symptoms and/or images. We present a rare case of left-sided paraduodenal hernia at the ligament of Treitz, followed by a review of the literature. CASE PRESENTATION We report the case of a 20-year-old patient with unusual, recurring abdominal pain in the past 3 months. There were no previous operations or past illnesses in the patient's history. The computed tomographic scan showed a misplacement of small bowel into the lesser sack. With high suspicion of an internal hernia, we performed a diagnostic laparoscopy, which revealed a Treitz hernia. The reduction and fixation could be carried out fully with minimally invasive surgery with an uneventful postoperative course and complete recovery. CONCLUSION A Treitz hernia is a rare cause of unspecific abdominal pain and the clinical signs are difficult to interpret. However, its knowledge may help to avoid emergency procedures and provide quick recovery of the patients. We recommend the laparoscopic approach as the first choice of treatment in all cases of internal hernia in the absence of peritoneal irritation or severe bowel obstruction.
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Ma Y, Ackermann T, Mathew MK, Naqash N. Incarcerated left paraduodenal hernia causing small and large bowel obstruction. ANZ J Surg 2019; 90:E9-E10. [PMID: 30845362 DOI: 10.1111/ans.15056] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 12/13/2018] [Indexed: 11/26/2022]
Affiliation(s)
- Yi Ma
- Department of Upper GI and Hepatobiliary Surgery, Monash Medical Centre, Melbourne, Victoria, Australia
| | - Travis Ackermann
- Department of Upper GI and Hepatobiliary Surgery, Monash Medical Centre, Melbourne, Victoria, Australia
| | - Mathen K Mathew
- Department of Upper GI and Hepatobiliary Surgery, Monash Medical Centre, Melbourne, Victoria, Australia
| | - Niyaz Naqash
- Department of Upper GI and Hepatobiliary Surgery, Monash Medical Centre, Melbourne, Victoria, Australia
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Khen-Dunlop N, Beaudoin S, Marion B, Rousseau V, Giuseppi A, Nicloux M, Grevent D, Salomon LJ, Aigrain Y, Lapillonne A, Sarnacki S. Segmental volvulus in the neonate: A particular clinical entity. J Pediatr Surg 2017; 52:454-457. [PMID: 28443816 DOI: 10.1016/j.jpedsurg.2016.10.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Revised: 10/03/2016] [Accepted: 10/04/2016] [Indexed: 12/13/2022]
Abstract
BACKGROUND Complete intestinal volvulus is mainly related to congenital anomalies of the so-called intestinal malrotation, whereas segmental volvulus appears as a distinct entity, mostly observed during the perinatal period. Because these two situations are still lumped together, the aim of this study was to describe the particular condition of neonatal segmental volvulus. STUDY DESIGN We analyzed the circumstances of diagnosis and management of 17 consecutives neonates operated for segmental volvulus more than a 10-year period in a single institution. During the same period, 19 cases of neonatal complete midgut volvulus were operated. RESULTS Prenatal US exam anomalies were observed in 16/17 (94%) of segmental volvulus, significantly more frequently than in complete volvulus (p=0.003). Intestinal malposition was described peroperatively in all cases of complete volvulus, but also in 4/17 segmental volvulus (23%). Intestinal resection was performed in 88% of segmental volvulus when only one extensive intestinal necrosis was observed in complete volvulus. Parenteral nutrition was required in all patients with segmental volvulus with a median duration of 50days (range 5-251). CONCLUSION Segmental volvulus occurs mainly prenatally and leads to fetal ultrasound anomalies. This situation, despite a limited length of intestinal loss, is associated to significant postnatal morbidity. TYPE OF THE STUDY Treatment study. LEVEL OF EVIDENCE Level IV.
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Affiliation(s)
- Naziha Khen-Dunlop
- AP-HP, Hôpital Necker-Enfants malades, Service de Chirurgie Pédiatrique Viscérale, Paris, France; Université Paris Descartes, Paris, France; EA 7328 FETUS, Hôpital Necker-Enfants malades, Paris, France.
| | - Sylvie Beaudoin
- AP-HP, Hôpital Necker-Enfants malades, Service de Chirurgie Pédiatrique Viscérale, Paris, France; Université Paris Descartes, Paris, France
| | - Blandine Marion
- AP-HP, Hôpital Necker-Enfants malades, Service de Chirurgie Pédiatrique Viscérale, Paris, France
| | - Véronique Rousseau
- AP-HP, Hôpital Necker-Enfants malades, Service de Chirurgie Pédiatrique Viscérale, Paris, France
| | - Agnes Giuseppi
- AP-HP, Hôpital Necker-Enfants malades, Service de Néonatalogie, Paris, France
| | - Muriel Nicloux
- AP-HP, Hôpital Necker-Enfants malades, Service de Néonatalogie, Paris, France
| | - David Grevent
- AP-HP, Hôpital Necker-Enfants malades, Service de Radiologie Pédiatrique, Paris, France
| | - Laurent J Salomon
- AP-HP, Hôpital Necker-Enfants malades, Maternité, Paris, France; Université Paris Descartes, Paris, France; EA 7328 FETUS, Hôpital Necker-Enfants malades, Paris, France
| | - Yves Aigrain
- AP-HP, Hôpital Necker-Enfants malades, Service de Chirurgie Pédiatrique Viscérale, Paris, France; Université Paris Descartes, Paris, France
| | - Alexandre Lapillonne
- AP-HP, Hôpital Necker-Enfants malades, Service de Néonatalogie, Paris, France; Université Paris Descartes, Paris, France
| | - Sabine Sarnacki
- AP-HP, Hôpital Necker-Enfants malades, Service de Chirurgie Pédiatrique Viscérale, Paris, France; Université Paris Descartes, Paris, France
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Gerdes C, Akkermann O, Krüger V, Gerdes A, Gerdes B. Incarceration of Meckel's diverticulum in a left paraduodenal Treitz' hernia. World J Clin Cases 2015; 3:732-735. [PMID: 26301234 PMCID: PMC4539413 DOI: 10.12998/wjcc.v3.i8.732] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Revised: 05/16/2015] [Accepted: 07/09/2015] [Indexed: 02/05/2023] Open
Abstract
Meckel’s diverticula incarcerated in a hernia were first described anecdotally by Littré, a French surgeon, in 1700. Meckel, a German anatomist and surgeon, explained the pathophysiology of this disease 100 years later. In addition, a congenital paraduodenal mesocolic hernia, known as a Treitz hernia, is a rare cause of small bowel obstruction. These hernias are caused by an abnormal rotation of the primitive midgut, resulting in a right or left paraduodenal hernia. We treated a patient presenting with pain and diagnosed extraluminal air in the abdomen after a computed tomography examination. We performed a laparotomy and found a combination of these two seldomly occurring congenital diseases, incarceration and perforation of Meckel’s diverticulum in a left paraduodenal hernia. We performed a thorough review of the literature, and this report is the first to describe a patient with a combination of these two rare conditions. We considered the case regarding the variety of terminology as well as the treatment options of these conditions.
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