Bhagvat Shirish, Mirkhushal Najmeh, Dharmadhikari Shalmali, Ramteke Abhipray P, Venkateswaran Rajalakshmi
General Surgery, Grant Medical College and Sir JJ Group of Hospitals, Mumbai, IND.
Cureus. 2024 Dec 17;16(12):e75878. doi: 10.7759/cureus.75878. eCollection 2024 Dec.
Internal hernias are one of the rare causes of intestinal obstruction and usually is the diagnosis of exclusion. Para-duodenal hernias (PDH) are rare congenital disorders that occur due to malrotation of the midgut in the embryonic phase of development. They can be asymptomatic or can present as an incarcerated, strangulated, or even obstructed internal hernia. It is difficult to diagnose clinically and often requires supportive radiological investigations. Herewith, we present a case of a 30-year-old male who presented with a short history of persistent pain in the abdomen. Contrast-enhanced computed tomography (CECT) showed the presence of an uncomplicated left para-duodenal hernia. Emergency diagnostic laparoscopy was done in view of abdominal tenderness, and a diagnosis of incarcerated PDH was made. The PDH was then tackled laparoscopically. We present this case to highlight the importance of suspecting a PDH with complications in an acute abdomen and the need to intervene surgically based on clinical judgment.
内疝是肠梗阻的罕见病因之一，通常是通过排除其他病因后才能做出诊断。十二指肠旁疝（PDH）是一种罕见的先天性疾病，是由于中肠在胚胎发育阶段发生旋转不良所致。它们可以无症状，也可以表现为嵌顿性、绞窄性甚至梗阻性内疝。临床诊断困难，通常需要辅助影像学检查。在此，我们报告一例30岁男性患者，其腹部持续疼痛病史较短。增强计算机断层扫描（CECT）显示存在单纯性左十二指肠旁疝。鉴于腹部压痛，进行了急诊诊断性腹腔镜检查，诊断为嵌顿性PDH。然后通过腹腔镜处理了该PDH。我们展示此病例以强调在急腹症中怀疑有并发症的PDH的重要性以及根据临床判断进行手术干预的必要性。
