Yang Wei-liang, Yan Chao-qi, Liu Tao, Zhao Zhi, Zhang Jian-guo, Pei Jian-hua
Department of General Surgery, The Second Affiliated Hospital, Harbin Medical University, Harbin 150086, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2005 Nov;8(6):490-2.
To summarize the experience of diagnosis and treatment for paraduodenal hernia (PDH).
The clinical data of 16 cases with PDH surgically treated from 1962 to 2003 were analyzed retrospectively.
The average age of the patients was 36 years old. There were 13 cases with left PDH (Landzerts hernia) and 3 cases with right PDH (Waldeyer's hernia). Ten patients usually had no symptoms, while acute abdominal pain occurred after full food in 3 case and after vigorous movement in 13 cases respectively. X-ray revealed complete or incomplete intestinal obstruction in 12 cases, while ultrasonography and CT revealed dilated cystic jejunal loop between the pancreas and the stomach in 6 cases. Fourteen cases (87.5%) were misdiagnosed before operation. The hospital stay ranged from 10 to 13 days. All patients were followed up from 2 to 4 years without recurrence.
With high misdiagnostic rate, it is the key to perform exploratory operation for suspicious PDH.
总结十二指肠旁疝（PDH）的诊断与治疗经验。
回顾性分析1962年至2003年手术治疗的16例PDH患者的临床资料。
患者平均年龄36岁。左PDH（Landzerts疝）13例，右PDH（Waldeyer疝）3例。10例患者通常无症状，3例分别在饱食后、13例在剧烈运动后出现急性腹痛。X线显示12例有完全或不完全性肠梗阻，超声及CT显示6例胰腺与胃之间有扩张的空肠襻。14例（87.5%）术前误诊。住院时间10至13天。所有患者随访2至4年无复发。
PDH误诊率高，对可疑PDH行探查手术是关键。
