Hussein Maher, Khreiss Mohamed, Al-Helou Georges, Alaeddine Mohamed, Elias Elias, Abi Saad George S
Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon.
Surg Laparosc Endosc Percutan Tech. 2012 Feb;22(1):e28-30. doi: 10.1097/SLE.0b013e31823f3798.
An internal hernia is any protrusion of a solid organ or a hollow viscus through a defect within the abdominal cavity. Paraduodenal hernias (PDHs) are rare; however, they are the most common form of internal hernias. We present a case of a left PDH in a 59-year-old healthy woman who presented with acute bowel obstruction. The PDH was diagnosed preoperatively using computed tomography scan. Laparoscopic exploration of the abdomen was then performed for reduction of the hernia. Using this approach, we managed to close the defect with intracorporeal continuous suturing with the aim of avoiding future incarceration. The patient was discharged 60 hours postoperation in a good condition, compared with 3 to 28 days postoperation reported in most of the literature. Our search of the english language literature revealed only 16 reported cases of laparoscopic repair of PDH. We believe that laparoscopic treatment of PDH in experienced hands is recommended in selected cases as it decreases the morbidity and significantly shortens the hospital stay.
内疝是指固体器官或中空脏器通过腹腔内的缺损突出。十二指肠旁疝(PDH)较为罕见;然而,它们是内疝最常见的形式。我们报告一例59岁健康女性的左侧PDH,该患者表现为急性肠梗阻。术前通过计算机断层扫描诊断出PDH。随后进行腹腔镜腹部探查以还纳疝。采用这种方法,我们通过体内连续缝合成功闭合了缺损,目的是避免未来发生嵌顿。患者术后60小时状况良好出院,而大多数文献报道的术后住院时间为3至28天。我们检索英文文献发现,仅有16例关于腹腔镜修复PDH的报道病例。我们认为,在经验丰富的医生手中,对于特定病例推荐采用腹腔镜治疗PDH,因为它可降低发病率并显著缩短住院时间。