Here in we present a 53 year old previously healthy woman was admitted to the emergency department due to acute abdominal pain and recurrent vomiting.
On physical examination she appeared dehydrated. She was tachycardic up to a heart rate of 110 but with normal blood pressure and no fever. Her abdomen was diffusely tender but with no signs of peritonitis. Lab results were normal except for an elevated white cell count of 14,000. Abdominal x-ray demonstrated dilated small bowel loops with air fluid levels. Abdominal CT scan showed dilated small bowel loops concentrated in a left Paraduodenal fossa. A preoperative diagnosis of small bowel obstruction due to a left Paraduodenal hernia was made and a laparoscopic operation was performed. Multiple dilated small bowel loops were reduced from the hernia sac and the hernia defect was sutured. Her postoperative course was uneventful. She was discharged on postoperative day 3 with no abdominal pain tolerating regular diet.
Incarcerated left paraduodenal hernia is a rare entity that can cause small bowel obstruction. It should be on the list of differential diagnosis and can be repaired laparoscopically
Session: Video Channel
Program Number: V062