Small paraduodenal hernias

H. Freund and Y. Berlatzky

During an 18-month period, five patients ranging in age from 3 1/2 to 79 years old were treated for small paraduodenal hernia. Three had acute strangulated obstruction, while in the other two patients the hernia was found incidentally, during surgery for other causes. As the mortality of obstructing internal hernias exceeds 50%, all paraduodenal hernias, even small and asymptomatic ones, should be considered an operable condition. The operating surgeon must be aware of the various types and locations of paraduodenal hernias and look for them whenever operating for unexplained abdominal pain or obstruction. Contrary to the common assumptioh that paraduodenal hernias are rare congenital anomalies, we believe the rarity of this condition to be due to insufficient attention to the clinical picture and inadequate exploration of the paraduodenal hernia during laparotomy.