Left Para-duodenal hernia with distal bowel ischemia: An unusual presentation of the internal hernia: A case report and literature review

Q4 Medicine Radiology Case Reports Pub Date : 2025-02-01 Epub Date: 2024-12-02 DOI:10.1016/j.radcr.2024.11.005
Manali Bhatta MD , Shailendra Katwal MD , Bigyan Paudel MD
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Abstract

Internal hernias, including Left para duodenal Hernias (LPDH), are rare and challenging to diagnose due to their nonspecific symptoms and complex anatomical presentation. This report presents a unique case of a 29-year-old female with preoperatively diagnosed uncomplicated LPDH, complicated by distal bowel ischemia—a manifestation not extensively documented in existing literature. Initial imaging revealed dilated jejunal loops indicative of LPDH, with subsequent contrast-enhanced computed tomography (CECT) showing ischemic changes in bowel segments distal to the hernia. Surgical exploration confirmed 120 cm of gangrenous bowel, necessitating resection and jejunostomy. This case highlights the diagnostic and therapeutic challenges of LPDH and highlights the crucial role of advanced imaging in identifying associated complications.
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左十二指肠旁疝伴远端肠缺血:一种不寻常的内疝表现:1例报告及文献复习
内疝,包括左十二指肠旁疝(LPDH),由于其非特异性症状和复杂的解剖表现,是罕见且具有挑战性的诊断。本文报告一例29岁女性患者,术前诊断为无并发症的LPDH,并发远端肠缺血,这一表现在现有文献中没有广泛记载。初步影像学显示空肠袢扩张,提示LPDH,随后的对比增强计算机断层扫描(CECT)显示疝远端肠段缺血改变。手术探查证实120公分肠坏疽,需要切除及空肠造口术。本病例强调了LPDH的诊断和治疗挑战,并强调了先进成像在识别相关并发症中的关键作用。
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来源期刊
Radiology Case Reports
Radiology Case Reports Medicine-Radiology, Nuclear Medicine and Imaging
CiteScore
1.10
自引率
0.00%
发文量
1074
审稿时长
30 days
期刊介绍: The content of this journal is exclusively case reports that feature diagnostic imaging. Categories in which case reports can be placed include the musculoskeletal system, spine, central nervous system, head and neck, cardiovascular, chest, gastrointestinal, genitourinary, multisystem, pediatric, emergency, women''s imaging, oncologic, normal variants, medical devices, foreign bodies, interventional radiology, nuclear medicine, molecular imaging, ultrasonography, imaging artifacts, forensic, anthropological, and medical-legal. Articles must be well-documented and include a review of the appropriate literature.
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