Bhatta Manali, Katwal Shailendra, Paudel Bigyan
Department of Radiology, Grande International Hospital, Kathmandu, Nepal.
Department of Radiology, Dadeldhura Subregional Hospital, Dadeldhura, Nepal.
Radiol Case Rep. 2024 Dec 2;20(2):1165-1169. doi: 10.1016/j.radcr.2024.11.005. eCollection 2025 Feb.
Internal hernias, including Left para duodenal Hernias (LPDH), are rare and challenging to diagnose due to their nonspecific symptoms and complex anatomical presentation. This report presents a unique case of a 29-year-old female with preoperatively diagnosed uncomplicated LPDH, complicated by distal bowel ischemia-a manifestation not extensively documented in existing literature. Initial imaging revealed dilated jejunal loops indicative of LPDH, with subsequent contrast-enhanced computed tomography (CECT) showing ischemic changes in bowel segments distal to the hernia. Surgical exploration confirmed 120 cm of gangrenous bowel, necessitating resection and jejunostomy. This case highlights the diagnostic and therapeutic challenges of LPDH and highlights the crucial role of advanced imaging in identifying associated complications.
内疝，包括左十二指肠旁疝（LPDH），因其症状不具特异性且解剖表现复杂，故而罕见且诊断颇具挑战。本报告呈现了一例独特病例，一名29岁女性术前被诊断为无并发症的LPDH，但并发了远端肠缺血，这一表现现有文献中未见广泛记载。初始影像学检查显示空肠袢扩张，提示LPDH，随后的增强计算机断层扫描（CECT）显示疝远端肠段有缺血改变。手术探查证实有120厘米肠管坏疽，需行切除及空肠造口术。该病例凸显了LPDH的诊断和治疗挑战，并突出了先进影像学在识别相关并发症方面的关键作用。
