title: Left subdiaphragmatic paraganglioma supplied by contralateral right renal artery.
abstract: BACKGROUND
  Paragangliomas are neuroendocrine tumors of the autonomic nervous system that arise from neural crest cells. Paragangliomas are typically extra-adrenal, non-functional and can be discovered incidentally, posing diagnostic and therapeutic challenges.
  
  
  METHODS
  We present the unusual case of a young man who presented with an acute abdomen secondary to small bowel obstruction, and was found to have an incidental left-sided subdiaphragmatic paraganglioma supplied by a branch of the contralateral right renal artery.
  
  
  CONCLUSIONS
  Emergent laparotomy revealed an internal hernia as the source of the small bowel obstruction. Initial attempts to remove an incidental left subdiaphragmatic mass were aborted because of bleeding. Subsequently, after preoperative superselective embolization of the feeding vessel arising from the right renal artery, the mass was successfully resected. Pathology was consistent with a paraganglioma.
  
  
  CONCLUSIONS
  This report highlights the rarity of the location and blood supply of an incidental left subdiaphragmatic paraganglioma found in the setting of a small bowel obstruction.
authors.affiliation: Universidad Autonoma de Guadalajara, Mexico.
authors.forename: Jaime D
authors.initials: JD
authors.lastname: Martinez
authors.forename: Benjamin
authors.initials: B
authors.lastname: Zendejas
authors.forename: Juan Pablo Sánchez
authors.initials: JP
authors.lastname: Luna
authors.forename: Joseph
authors.initials: J
authors.lastname: Lopez
authors.forename: Sergio Sánchez
authors.initials: SS
authors.lastname: Luna
authors.forename: Federico
authors.initials: F
authors.lastname: Mendoza-Sánchez
authors.forename: David R
authors.initials: DR
authors.lastname: Farley