A rare cause of intestinal obstruction: right paraduodenal hernia

Internal herniation is an extremely rare cause of intestinal obstruction. Paraduodenal hernias result from abnormal rotation of the bowel. Symptoms that may range from recurrent abdominal pain to acute obstruction may occur. If it is not diagnosed and treated in time, the disease may result in intestinal ischemia. This article aimed to present the diagnosis and treatment process of a 47-year-old male presenting with acute abdomen symptoms by evaluating retrospectively with the accompaniment of literature. During the abdominal exploration of the patient, nearly all of the intestines were observed to be herniated from the right paraduodenal region to the posterior area. The opening of the hernial sac was repaired primarily by reducing the intestinal bowel loops into the intraperitoneal region. The patient undergoing anastomosis by performing resection of the ischemic part after reduction of herniated bowel loops was discharged uneventfully on the post-operative 10th day. Paraduodenal hernia is a condition that should be considered in patients with abdominal pain and intestinal obstruction symptoms. Early diagnosis is of vital importance to prevent the complications which can develop.

Nadir bir intestinal obstrüksiyon sebebi: sað paraduodenal herni

Ýnternal herniasyon son derece nadir görülen bir intestinal obstrüksiyon sebebidir. Paraduodenal herniler, barsaðýn anormal rotasyonu sonucunda oluþmaktadýr. Tekrarlayýcý karýn aðrýlarýndan akut barsak týkanýklýklarýna kadar deðiþebilen semptomlar oluþturmaktadýr. Zamanýnda taný konulup tedavi edilmezse barsakta iskemi ile sonuçlanabilmektedir. Bu yazýda, akut karýn bulgularýyla gelen 47 yaþýnda erkek hastanýn taný ve tedavi süreci retrospektif olarak deðerlendirilerek literatür eþliðinde sunulmasý amaçlanmýþtýr. Karýn eksplorasyonunda ince barsaklarýn tamamýna yakýn kýsmýnýn sað paraduodenal bölgeden posteriora doðru herniye olduðu görüldü. Ýnce barsak anslarý intraperitoneal alana redükte edilerek herni kesesinin giriþi primer olarak tamir edildi. Redüksiyon sonrasý iskemik kýsým rezeke edilerek anastomoz yapýlan hasta onuncu günde sorunsuz taburcu edildi.
Paraduodenal herni, karýn aðrýsý ve intestinal obstrüksiyon bulgularý olan hastalarda akýlda tutulmasý gereken bir durumdur. Geliþebilecek komplikasyonlarý önleyebilmek için erken taný hayati öneme sahiptir.