N M Girish Kumar, S P Preethi, Ravi Megha
JSS Academy of Higher Education and Research, Mysore, Karnataka, India.
General Surgery, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India.
BMJ Case Rep. 2025 Jun 19;18(6):e265778. doi: 10.1136/bcr-2025-265778.
Paraduodenal hernia is the most common type of internal hernia, accounting for 30-50% of cases. It often results from congenital defects caused by errors during intestinal rotation and fixation during embryonic development. These hernias can present as nonspecific abdominal pain or acute intestinal obstruction, making diagnosis challenging. In this case report, a young man, in his early 30s, presented with acute upper abdominal pain, obstipation and distension. Initial radiological investigations were inconclusive, prompting a contrast-enhanced CT scan, which revealed a left paraduodenal hernia with encapsulated jejunal loops. Emergency laparotomy confirmed the diagnosis, and the hernia was repaired by reducing the bowel loops, excising the hernial sac and closing the defect. Paraduodenal hernias carry a high risk of complications such as strangulation, bowel necrosis and perforation, making early diagnosis and surgical intervention crucial. This case highlights the importance of considering internal hernias in patients with unexplained recurrent abdominal pain, particularly in the absence of previous surgeries.
十二指肠旁疝是最常见的内疝类型，占病例的30%-50%。它通常源于胚胎发育过程中肠道旋转和固定错误导致的先天性缺陷。这些疝可表现为非特异性腹痛或急性肠梗阻，诊断具有挑战性。在本病例报告中，一名30岁出头的年轻男性出现急性上腹痛、便秘和腹胀。最初的影像学检查结果不明确，于是进行了增强CT扫描，结果显示为左侧十二指肠旁疝，伴有被包裹的空肠袢。急诊剖腹手术确诊了病情，通过将肠袢复位、切除疝囊并封闭缺损对疝进行了修复。十二指肠旁疝具有较高的并发症风险，如绞窄、肠坏死和穿孔，因此早期诊断和手术干预至关重要。本病例突出了对于不明原因反复腹痛患者，尤其是既往无手术史的患者，考虑内疝的重要性。
