Paraduodenal hernia presenting as unexplained recurrent abdominal pain

Area of Science:

• Gastroenterology
• Surgical Case Reports

Background:

• Intermittent abdominal pain is a common but often challenging clinical presentation.
• Previous investigations for recurrent abdominal pain frequently include imaging and laboratory studies.
• Paraduodenal hernias are rare congenital abnormalities that can cause abdominal symptoms.

Observation:

• A 29-year-old female nurse experienced recurrent, self-resolving episodes of abdominal pain over five years.
• Extensive prior investigations, including ultrasound and CT scans, failed to establish a diagnosis.
• The patient's symptoms were previously attributed to psychosomatic causes or irritable bowel syndrome.

Findings:

• A left paraduodenal hernia was diagnosed via enteroclysis during a recent admission.
• Enteroclysis, a specialized barium study, proved effective in visualizing the hernia.

Implications:

• This case underscores the importance of including paraduodenal hernias in the differential diagnosis of unexplained intermittent abdominal pain.
• Advanced imaging or diagnostic procedures like enteroclysis may be necessary when initial investigations are inconclusive.
• Accurate diagnosis of rare conditions like paraduodenal hernias is crucial for appropriate patient management and symptom resolution.