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Paraduodenal hernia: a treatable cause of upper gastrointestinal tract symptoms

H Y Yoo1, J Mergelas, D G Seibert

  • 1Department of Medicine, Robert C. Byrd Health Sciences Center, West Virginia University School of Medicine, Morgantown 26506, USA.

Journal of Clinical Gastroenterology
|October 18, 2000
PubMed

Insights

Paraduodenal hernia (PDH), a rare condition from intestinal malrotation, often causes chronic gastrointestinal issues. Surgical repair effectively resolves these symptoms, highlighting PDH as a treatable cause of UGI distress.

Area of Science:

  • Gastroenterology
  • Abdominal Surgery
  • Radiology

Background:

  • Paraduodenal hernia (PDH) is a rare congenital condition linked to intestinal malrotation.
  • The clinical presentation and surgical outcomes of non-catastrophic PDH are not well-documented.

Observation:

  • A review of 294 barium upper gastrointestinal (UGI) series and small bowel follow-throughs identified 6 suspected PDH cases.
  • Three patients with suspected PDH underwent surgery, confirming a 1% prevalence of right PDH.
  • Common preoperative symptoms included nausea, bilious vomiting, and right upper quadrant pain.

Findings:

  • Surgical repair of PDH led to complete resolution of chronic gastrointestinal symptoms.
  • Preoperative upper endoscopy was not effective in diagnosing PDH.
  • Preoperative computerized tomography (CT) scans were diagnostic for right PDH in two patients.

Implications:

  • PDH frequently presents with chronic UGI symptoms that can be resolved with surgical intervention.
  • Upper endoscopy is not a reliable method for excluding PDH.
  • CT imaging is a valuable tool for diagnosing PDH.

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