Obstructed Right Paraduodenal Hernia: An Unusual Cause of Small Bowel Gangrene.

Paraduodenal hernias, especially right sided, are extremely rare entities that are difficult to diagnose due to their uncommon presentation. Some may experience small bowel obstruction. Such patients will have a guarded prognosis if complicated by sepsis due to strangulation or perforation. Hereby, we present a case report of a 15-year-old male who presented with a three-hour history of severe colicky abdominal pain. A computed tomography scan revealed acute small bowel obstruction. On laparotomy, it was found that the majority of the small bowel loops were obstructed in a sac on the right side of duodenojejunal flexure and had become gangrenous, suggesting strangulated right paraduodenal hernia. Due to extensive small bowel resection, this patient succumbed in the postoperative period. This case demonstrates how complex the diagnosis and management of this entity are, as well as how fatal the outcomes can be. Early diagnosis and surgical intervention remain the mainstay of treatment.