An unusual variant of a left paraduodenal hernia diagnosed and treated by laparoscopic surgery: report of a case.
An 80-year-old woman who had undergone both a cholecystectomy and an appendectomy presented with intermittent abdominal pain. Computed tomography (CT) revealed an encapsulated circumscribed cluster of jejunal loops in the left upper quadrant. The hernia orifice was adjacent to the left side of the superior mesenteric artery and vein. An upper gastrointestinal series also revealed a cluster of jejunal loops, suggesting the possibility of an internal hernia. Laparoscopic surgery was performed. The hernia orifice was found to be caused by abnormal adhesion between the transverse mesocolon and the jejunum mesentery. An adhesiotomy reduced the jejunum entrapped in the hernia. The hernia space was a large mesocolic fossa composed of transverse mesocolon and mesentery, continuing to the splenic flexure. The hernia was classified as a variant of paraduodenal hernia.
Uchiyama
Shuichiro
S
Department of Surgical Oncology and Regulation of Organ Function, Miyazaki University School of Medicine, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan.
Imamura
Naoya
N
Hidaka
Hideki
H
Maehara
Naoki
N
Nagaike
Koki
K
Ikenaga
Naoki
N
Hotokezaka
Masayuki
M
Chijiiwa
Kazuo
K
D015746:Abdominal Pain / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D004378:Duodenal Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006547:Hernia / Q000150:complications / Q000000981:diagnostic imaging; D059685:Herniorrhaphy; D006801:Humans; D010535:Laparoscopy; D014057:Tomography, X-Ray Computed