Brehm V, Smithuis R, Doornebosch P G
Department of Surgery, Rijnland Hospital, Leiderdorp, The Netherlands.
Acta Chir Belg. 2006 Jul-Aug;106(4):436-7. doi: 10.1080/00015458.2006.11679925.
We present the case of a 54-year old woman who presented twice at our emergency department with progressive abdominal pain. Over the last few years, multiple short periods of abdominal pain had occurred: the pain always resolved spontaneously after a few hours. She had no past medical history. CT scan revealed a sac-like mass of small bowel loops to the left of the ligament of Treitz, consistent with the diagnosis of a left paraduodenal hernia. On laparotomy, a left paraduodenal hernia with incarceration of small bowel loops was found; the herniated loops were reduced and the hernia orifice closed. The anatomy, treatment and importance of considering this uncommon diagnosis when examining a patient with acute small bowel obstruction are discussed.
我们报告了一例54岁女性患者，她因进行性腹痛两次前来我院急诊科就诊。在过去几年中，曾多次出现短暂的腹痛：疼痛总是在数小时后自行缓解。她既往无病史。CT扫描显示在Treitz韧带左侧有一个囊状的小肠袢肿块，符合左十二指肠旁疝的诊断。剖腹手术时，发现一个伴有小肠袢嵌顿的左十二指肠旁疝；将疝出的肠袢复位并封闭疝孔。本文讨论了在检查急性小肠梗阻患者时考虑这一罕见诊断的解剖学、治疗方法及重要性。
