A Retrospective Analysis of Paraduodenal Internal Hernia: A Case Series of Nine Patients

Abstract

Internal abdominal hernias are a rare condition, making up only 0.9% of all cases of intestinal obstruction. Among these, Paraduodenal hernias are exceptionally rare, comprising approximately 53% of all internal hernias. They are more frequently found in the left Paraduodenal fossa compared to the right, have a higher incidence in males and are primarily congenital in nature. A Left Paraduodenal hernia represents a congenital defect situated posterior to the inferior mesenteric vein and the left branches of the middle colic artery, located to the left of the fourth part of the duodenum. Most patients are diagnosed with this condition between their fourth and sixth decades of life. Delay in diagnosis can lead to surgical complications such as bowel obstruction, gangrene, and perforation. The preferred imaging method for diagnosis is typically a CT scan. The treatment of choice is either an open exploratory laparotomy or laparoscopic surgery. In this report, we present findings from nine cases of Left Paraduodenal hernias with management involving exploratory laparotomy for seven adult patients and laparoscopic surgery for two paediatric cases.