Walkner Stephanie, Nebiker Christian A
Department of Surgery, Hospital of Aarau, Aarau 5001, Switzerland.
J Surg Case Rep. 2019 Dec 11;2019(12):rjz337. doi: 10.1093/jscr/rjz337. eCollection 2019 Dec.
With an incidence of less than 1%, paraduodenal hernias are very rare but account for ~0.2-5.8% of mechanical small bowel obstruction and carry a mortality rate of 20-50%. Right-sided paraduodenal hernias are three times less frequent than left-sided paraduodenal hernias. We report the case of a 37-year-old man who suffered from colicky abdominal pain accompanied by vomiting. The computed tomography scan showed a mechanical ileus, caused by a presumed paraduodenal hernia, and we chose an elective laparoscopic surgical approach. The patient recovered quickly and was discharged on the second postoperative day. Paraduodenal hernias are a diagnostic challenge as they are typically characterized by long-term non-specific abdominal symptoms and are only detected in the event of acute intestinal obstruction. Until now, laparoscopic therapy has only been described in eight case reports and we review this rare condition and the surgical options.
十二指肠旁疝的发病率低于1%,非常罕见,但占机械性小肠梗阻的0.2 - 5.8%,死亡率为20 - 50%。右侧十二指肠旁疝的发生率比左侧十二指肠旁疝低三倍。我们报告一例37岁男性,他患有绞痛性腹痛并伴有呕吐。计算机断层扫描显示为机械性肠梗阻,推测由十二指肠旁疝引起,我们选择了择期腹腔镜手术方法。患者恢复迅速,术后第二天出院。十二指肠旁疝是一个诊断难题,因为它们通常表现为长期的非特异性腹部症状,仅在急性肠梗阻时才被发现。到目前为止,腹腔镜治疗仅在八篇病例报告中有所描述,我们对这种罕见疾病及其手术选择进行综述。