Intestinal obstruction secondary to left paraduodenal hernia

An internal hernia—congenital or acquired—is a protrusion of bowel through an opening in the peritoneum or mesentery. Internal hernias are the etiology of <2% of intestinal obstructions, with paraduodenal hernias being the most common type of congenital internal hernia. We report a case of a left paraduodenal hernia (LPDH) combined with partial small bowel obstruction in a 69-year-old male with recurrent abdominal pain of 2 years duration and no previous abdominal surgeries. An abdominal computed tomography scan showed an agglomeration of small bowel loops in the left upper quadrant but failed to yield a clear diagnosis. Surgical intervention provided definitive diagnosis and treatment of the LPDH. We additionally review the literature regarding anatomy, pathogenesis, diagnosis and treatment of this uncommon hernia. Intestinal obstruction secondary to an internal hernia is a rare entity; however, delayed diagnosis and surgical intervention may result in significant morbidity and mortality.