Diagnosis of A large Left Paraduodenal Hernia: a case report

Internal hernia is a rare cause of intestinal obstruction and most cases of internal hernia are left paraduodenal hernia. It typically involves the fossa of Landzert just lateral to the fourth portion of the duodenum. Patients with left paraduodenal hernia do not have specific clinical manifestations and preoperative radiological diagnosis is difficult. Mortality increases significantly with delay in surgical treatment. It is difficult to diagnose large left paraduodenal hernia because the grouped bowel loops not easy to look like an agglomerated mass. We now present a case of large left paraduodenal hernia which was not diagnosed in preoperative images. By retrospectively reviewing the images, we correlate the operative and the imaging findings and propose some clues that may increase the accuracy of diagnosis.