Left Paraduodenal Hernia As a Rare Cause of Small Bowel Obstruction in Elderly: A Case Report and Review of Literature

Weerapat Suwanthanma MD*, Chakrapan Euanorasetr MD*, Sarash Soom-im MD*, Sarinda Lertbannaphong MD*

Affiliation : * Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

The authors presented a case of left paraduodenal hernia as a cause of closed loop small bowel obstruction in an elderly patient. Internal hernias are a rare cause of intestinal obstruction. Paraduodenal hernias are the most frequent especially left sided, which are believed to be the result of malrotation of the midgut during embryonic period. The clinical presentations varied, ranging from asymptomatic, chronic abdominal pain, or acute abdominal pain as acute abdomen. Most of the patients usually have early presentation in adult life with average age of 38.5 years at time of diagnosis. Late presentation in elderly patient (>70 years) is very rare due to its congenital in origin. This clinical entity is a diagnostic challenge, which happened in our case. When the diagnosis is late, the complication develops and may contribute to a fatal outcome if left untreated. Herein, the authors reported our case of left paraduodenal hernia with late presentation at age of 80, and reviewed literature.

Keywords : Paraduodenal hernia, Small bowel obstruction, Elderly

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