A left paraduodenal hernia causing bowel obstruction: a case report

Paraduodenal hernias (PDHs) are rare congenital internal hernias, constituting 50% of internal hernias and 0.2%-0.9% of small bowel obstructions. Left PDHs are more common and arise from midgut malrotation during embryonic development. We present the case of a 59-year-old male with acute small bowel obstruction caused by a left PDH. Imaging revealed clustered small bowel loops in the left upper quadrant, a hallmark of left PDH. Diagnostic laparoscopy confirmed the condition but was converted to open surgery due to dense adhesions. The herniated loops, initially edematous, were viable after reduction and warm compression. The hernia orifice was closed with non-absorbable sutures. Early diagnosis using imaging, particularly CT, is crucial, with findings such as clustered bowel loops, displaced structures, and engorged mesenteric vessels converging at the hernia orifice. Surgical intervention is the definitive treatment, highlighting the importance of prompt recognition to prevent complications and ensure favorable outcomes.