Paraduodenal hernia with associated intestinal malrotation and Meckel's diverticulum

DOI
  • Funakoshi Saori
    Department of Gastroenterological and General Surgery, Kyorin University School of Medicine, Tokyo, Japan Gastroenterological Surgery, Showa general hospital, Tokyo, Japan
  • Kaneko Susumu
    Gastroenterological Surgery, Showa general hospital, Tokyo, Japan
  • Yamaguchi Hirokazu
    Gastroenterological Surgery, Showa general hospital, Tokyo, Japan
  • Kaminishi Michio
    Gastroenterological Surgery, Showa general hospital, Tokyo, Japan Tamaryokuseikai Foundation, Tokyo, Japan

Bibliographic Information

Other Title
  • 腸回転異常症およびMeckel憩室を合併した右傍十二指腸ヘルニアの1例

Abstract

<p>A 33-year-old man was urgently transported to our hospital because he was experiencing acute abdominal pain and vomiting. A contrast-enhanced abdominal CT scan revealed intestinal obstruction and a sac-like appearance of the intestines. The small intestine within the internal hernia showed poor enhancement. The patient was diagnosed with strangulated intestinal obstruction due to a paraduodenal hernia, and emergency surgery was performed. Intraoperatively, we found that almost the entirety of the small intestine had protruded into the hernia sac, and some areas already showed ischemic changes. After the hernia sac was opened, blood flow to the ischemic intestine was immediately restored. On further evaluation of the hernia, we found that the horizontal duodenum was absent, and the cecum until the ascending colon were not fixed to the retroperitoneum. A Meckel's diverticulum, sized 4 cm, was found 60 cm from the end of the ileum. We intraoperatively diagnosed strangulated intestinal obstruction due to a right paraduodenal hernia with associated intestinal malrotation and an asymptomatic Meckel's diverticulum. Thereafter, we resected the Meckel's diverticulum, and performed an appendectomy. Some cases of intestinal malrotation may be associated with other congenital gastrointestinal anomalies ; however, it is difficult to detect these anomalies using preoperative imaging. Therefore, the presence of coexisting congenital anomalies, such as intestinal malformations, should be considered, preoperatively and intraoperatively, in young patients who present with intestinal obstruction without a previous laparotomy.</p>

Journal

Details 詳細情報について

  • CRID
    1390298610032251264
  • DOI
    10.11434/kyorinmed.54.187
  • ISSN
    1349886X
    03685829
  • Text Lang
    ja
  • Data Source
    • JaLC
  • Abstract License Flag
    Disallowed

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