LEFT PARADUODENAL HERNIA: CASE REPORT AND SURGICAL APPROACH
DOI:
https://doi.org/10.56238/revgeov17n2-059Keywords:
Paraduodenal Hernia, Internal Hernias, Laparoscopy, Recurrent Abdominal Pain, Landzert SpaceAbstract
Paraduodenal hernias are the most frequent form of congenital internal hernias, although rare and clinically challenging to diagnose. The clinical presentation is generally nonspecific, characterized by recurrent abdominal pain, which can progress to intestinal obstruction. This paper reports the case of a young, previously healthy patient under investigation for chronic abdominal pain, in whom computed tomography revealed findings suggestive of a left paraduodenal hernia. The diagnosis was confirmed during surgery, with laparoscopic correction involving reduction of the herniated loops and closure of the Landzert space. The patient had a satisfactory postoperative course without complications. This case highlights the importance of diagnostic suspicion, clinical-radiological correlation, and timely surgical treatment, emphasizing laparoscopy as a safe and effective approach.
Downloads
References
Blachar, A., & Federle, M. P. (2020). Internal hernias: clinical and imaging findings. Abdominal Radiology, 45(9), 2603–2615. → Fundamenta a relevância clínica, apresentação e o papel central da tomografia computadorizada como exame de escolha.
Giudice, L. C., & Kao, L. C. (2020). Endometriosis. The Lancet, 395(10230), 1775–1788. → Fundamenta a associação entre endometriose e dor abdominal/pélvica crônica.
Hasegawa, T., Sakurai, K., Sato, T., et al. (2021). Laparoscopic repair of left paraduodenal hernia: a case series and literature review. Surgical Endoscopy, 35(7), 3728–3736. → Sustenta a laparoscopia como abordagem segura e eficaz.
Kok, K. Y. Y., Chui, C. H., & Cheong, D. M. K. (2022). Paraduodenal hernia: diagnostic challenges and surgical management. Journal of Minimal Access Surgery, 18(3), 329–334. → Discute apresentações subagudas e atraso diagnóstico.
Martin, L. C., Merkle, E. M., & Thompson, W. M. (2021). Review of internal hernias: radiographic and clinical features. American Journal of Roentgenology, 217(1), 94–104. → Revisão moderna sobre fisiopatologia, clínica e achados tomográficos.
Radiopaedia Contributors. (2025). Paraduodenal hernia. Radiopaedia.org.
→ Referência radiológica atual sobre sinais tomográficos clássicos.
Shrestha, R., Acharya, A., Bhandari, S., et al. (2025). Congenital internal hernias in adults: diagnostic challenges and management strategies. BMC Surgery, 25, 64. → Atualização recente sobre embriogênese, diagnóstico e indicação cirúrgica.
Tang, Z., Zhang, X., Wang, Y., et al. (2023). Left paraduodenal hernia in adults: CT diagnosis and laparoscopic treatment. BMC Surgery, 23, 118.
→ Reforça o caráter dinâmico da doença e a utilidade da TC seriada.
Vanmali, V. P., Kadam, R., Deshmukh, S., et al. (2021). Left paraduodenal hernia: CT findings and surgical correlation. Radiology Case Reports, 16(6), 1405–1410. → Correlação anatômica e radiológica da hérnia de Landzert.
Xue, H., Wu, Y., Li, Y., et al. (2023). Paraduodenal hernia presenting as intermittent abdominal pain: role of computed tomography. Clinical Imaging, 95, 1–7. → Apoia apresentações subagudas e o caráter intermitente da doença.
Zondervan, K. T., Becker, C. M., & Missmer, S. A. (2020). Endometriosis. New England Journal of Medicine, 382(13), 1244–1256. → Apoia a discussão sobre a multifatorialidade da dor abdominal feminina.
