Intestinal obstruction due to a left paraduodenal hernia: a case report

INTRODUCTION: A left paraduodenal hernia is a rare congenital malrotational anomaly of the midgut that occurs in the paraduodenal fossa of Landzert to the left of the fourth duodenum. It is responsible for approximately 1% of small bowel obstructions. CASE PRESENTATION: We report a case of left paraduodenal hernia combined with small bowel obstruction in a 47-year-old Mediterranean woman who had a history of recurrent abdominal pain. An abdominal computed tomography scan showed a saclike mass clustered in the left upper quadrant but failed to yield a clear diagnosis. We describe the surgical anatomy of this disease and the emergency surgical management together with a short review of the literature. CONCLUSIONS: Even though a left paraduodenal hernia is rare, it must be suspected in any upper intestinal occlusion. The high morbidity and mortality rate of complicated cases should motivate preventive treatment in case of incidental operative discovery.