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The patient had a left paraduodenal hernia as shown in the plain x ray (fig 1). Abdominal computed tomography showed an isolated, distended small bowel loop around left upper and middle abdomen, suggestive of internal hernia (
figs 2, 3 and 4). He underwent laparoscopy at which a hernia sac was found at left paraduodenal region with a segment of upper jejunum inside (fig 5). The bowels were gently pulled back into peritoneal cavity and the hernic sac was sutured. Fortunately, the bowels within the sac were mildly erythematous but not necrotic. His postoperative course was smooth and he was discharged on the seventh day.
Figure 1 Plain abdominal radiograph showed a mass (arrowheads) with air-fluid content over the left abdomen.
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Figure 2 CT scans showed a mass lesion with bowel loops inside (arrowheads) anterior to left kidney.
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Figure 3 CT scans showed a segment | |||||||||
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Gut 2009 58: 982.[Extract] [Full Text] [PDF]
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