Öztaş Muharrem, Can Mehmet Fatih, Öztürk Erkan, Yağcı Gökhan
Department of General Surgery, Gülhane Military Medical Academy, Ankara, Turkey.
Ulus Cerrahi Derg. 2013 Jul 9;29(2):92-5. doi: 10.5152/UCD.2013.27. eCollection 2013.
The aim of this report is to assess clinical findings and surgical treatment of left paraduodenal hernia, which is an unusual type of internal herniation, in light of the literature. The diagnosis and treatment course of a 42-year-old male patient with findings of intestinal obstruction was assessed and presented together with literature search. The patient underwent surgery with a preliminary diagnosis of intestinal obstruction and the definitive diagnosis of internal herniation was made intraoperatively. Nearly two-thirds of the small intestine was found to be herniated into the retroperitoneal space from the left paraduodenal region. Small bowel loops were pulled out of the hernia sac and anatomically positioned in the intraperitoneal area. The hernia sac was repaired primarily. The patient was discharged on the fourth postoperative day, uneventfully. Left paraduodenal hernia should be considered as a part of differential diagnosis in patients who have recurring abdominal pain episodes accompanied by symptoms suggestive of intestinal obstruction. Timely diagnosis is important to prevent complications. Reduction of hernia content followed by primary repair of the defect appears to be a safe and effective treatment.
本报告旨在结合文献评估十二指肠旁疝(一种罕见的内疝类型)的临床发现及外科治疗。评估了一名有肠梗阻表现的42岁男性患者的诊断及治疗过程,并结合文献检索进行了阐述。该患者因初步诊断为肠梗阻接受手术,术中确诊为内疝。发现近三分之二的小肠从十二指肠旁区域疝入腹膜后间隙。将小肠袢从疝囊中拉出并按解剖位置放回腹腔区域。对疝囊进行了一期修补。患者术后第四天顺利出院。对于有反复腹痛发作并伴有肠梗阻症状的患者,应将十二指肠旁疝视为鉴别诊断的一部分。及时诊断对于预防并发症很重要。回纳疝内容物后对缺损进行一期修补似乎是一种安全有效的治疗方法。