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Arch Surg. 2009;144(3):288.

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Answer: Left Paraduodenal Hernia

This patient had a left paraduodenal hernia. Approximately 90 cm of proximal jejunum was herniated through the left paraduodenal fossa of Landzert (Figure 2). The bowel contained in the hernia sac was injected and fluid filled but was otherwise viable. The hernial defect was repaired primarily by approximating the surrounding loose areolar tissue with 3 interrupted 3-0 nonabsorbable sutures, taking care not to injure the duodenojejunal flexure medially and the inferior mesenteric vein laterally. The procedure was completed laparoscopically using 4 ports and was well tolerated.

Figure appears in full text version. Figure 2. Intraoperative view of the internal hernia orifice lateral to the duodenojejunal flexure after reduction of 90 cm of viable herniated jejunum.

Paraduodenal (also termed congenital mesocolic or mesentericoparietal) hernias represent less than 1% of all intestinal obstruction cases but account for approximately half of all internal hernias. They occur 3 times more commonly on the left side. By 1981, . . . [Full Text of this Article]

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Arch Surg. 2009;144(3):287.
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