Open Surgery Treatment of a Rare Cause of Intestinal Obstruction: Left Paradoudenal Hernia

Duong Trieu Trieu, Quoc Van Le, Hien Van Nguyen Department of Colon and Rectal Surgery, The 108 Military Central Hospital, Hanoi, VietnamCorrespondence: Quoc Van LeDepartment of Colon and Rectal Surgery, The 108 Military Central Hospital, No. 1 Tran Hung Dao Street, Bach Dang Ward, Hai Ba Trung District, Hanoi 100000, VietnamTel +84979966103Email levanquoch108@gmail.comAbstract: An internal hernia is the protrusion of visceral contents through a congenital or acquired defect in the peritoneum or mesentery within the abdominal cavity. In approximately 0.6– 5.8% of patients with small intestinal obstruction, the cause is internal hernia, with paraduodenal hernias accounting for approximately 40% of cases. Here, we present the case of a 51-year-old man diagnosed with obstruction of the small intestine caused by a hernia on the left side of the duodenum. The treatment involved returning the bowel loops to the normal position and closing the hernia pocket using Prolene 2.0 sutures. The duration of the surgery was 30 min. Five days later, the patient’s condition was stable and he was discharged from the hospital; at the 32-month postoperative follow-up, he remained in stable condition with no recurrence. An abdominal computed tomography scan is valuable for early diagnosis of paraduodenal hernia in the absence of complications, and the cause can be identified and the bowel returned to the normal position by endoscopic surgery, with closure of the hernia pocket if the intestine does not stick to the pocket.Keywords: open surgery, paraduodenal hernia, internal hernia, intestinal obstruction