Manuel Garcia, MD, Stephanie Keeth, DNP, Jeffrey Quigley, DO, Aarthy Kannappan, MD, Esther Wu, MD, Marcos Michelotti, MD, FACS, Keith Scharf, DO, FACS, FASMBS, Daniel P Srikureja, MD. Loma Linda University Health
Presented is a video case report of a 21 year old male presenting with non-specific abdominal complaints, including epigastric abdominal pain, nausea and vomiting, with CT evidence of right paraduodenal hernia. The patient underwent successful laparoscopic primary repair with 2-0 non-absorbable unidirectional suture, as shown in the video. Operative time was 135 minutes. He was discharged home the same day on regular diet, and recovered well with full resolution of his symptoms at follow up. These types of hernias are thought to arise from incomplete rotation of the midgut during embryologic development. Although congenital internal hernia is uncommon, paraduodenal hernia is the leading source of this pathology. Presentation widely varies including entirely asymptomatic, vague abdominal complaints, and up to high grade small bowel obstruction. Occasionally, congenital internal hernia repair is accompanied by lysis of Ladd's bands, appendectomy, and mesenteric lengthening, in our patient these were unnecessary as no Ladd's band were present, the appendix was in anatomic position, and there was no evidence of mesenteric foreshortening. The demonstrated laparoscopic repair is a safe and effective method for management of symptomatic congenital internal hernia.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 88136
Program Number: V154
Presentation Session: Hernia Videos Session
Presentation Type: Video
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