Right paraduodenal hernia: report of two cases and review of literature

Abstract

Paraduodenal hernia (PDH), a rare congenital anomaly, is a type of internal hernia which occurs due to a defect in the reduction and rotation of the midgut. On anatomical and embryological basis, PDH can be broadly divided into right- and Left PDH. Right PDH is rarer than its counterpart. We present two cases of Right PDH. The patientsy presented with a history of recurrent intestinal obstruction since childhood, which was managed conservatively, without a definitive diagnosis. Once they presented to us, a detailed clinical history and a barium meal follow- through clinched the diagnosis of PDH. Intra-operative findings correlated well with the clinical diagnosis. The jejunal loops had herniated through the fossa of Waldeyer. Reduction of hernia contents and excision of the hernia sac was carried out. Post-operatively, the patients are healthy and symptom-free at 4 and 3 years follow-up, respectively. The rarity of this condition and the need for early diagnosis, to prevent the high risk of bowel obstruction and strangulation, makes PDH one of the difficult challenges for the clinicians.