Paracecal hernia with intestinal obstruction managed with laparoscopic surgery: A case report

INTRODUCTION: Paracecal hernia is a rare cause of intestinal obstruction. PRESENTATION OF CASE: A 75-year-old man presented with abdominal pain for 4 days, vomiting, and obstipation. Physical examination was not conclusive. Abdominal radiograph suggested small intestinal obstruction, and computed tomography confirmed an obstructed paracecal hernia. Intraoperatively, the hernial sac was seen passing through the inferior ileocecal recess. The distal bowel was collapsed. The appendix was inflamed. The hernia was reduced and appendectomy was performed. The patient recovered without complications and was discharged on the fifth postoperative day. DISCUSSION: Internal hernia may be a cause of acute abdomen. Symptoms and signs may be nonspecific. Rapid recognition of the condition can prevent strangulation and ischemia of affected intestinal loops. Early resort to imaging examination will ensure quick diagnosis. CONCLUSION: Paracecal hernia is a rare cause of intestinal obstruction. Awareness of the imaging features will help avoid delay in diagnosis. Laparoscopic surgery appears to be a safe and feasible treatment.