Paraduodenal hernias in children: Etiology, treatment, and outcomes of a rare but real cause of bowel obstruction

Abukhalaf, obstructionSadi A.
Mustafa, Aya
Elqadi, Mohammad N.
Al Hammouri, Ahmad
Abuzaina, Khalil N.M.
Abukarsh, Radwan
Ghazzawi, Ihsan
Hassan, Shareef
Novotny, Nathan M.
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tINTRODUCTION: Paraduodenal Hernia (PDH) is the most common variant of internal hernia and occursmost often in males during their 4th–6thdecades of life. PDH in pediatric age group has rarely beenreported in literature with only five cases of age up to 10 years were reported. PDH is a rare cause ofintestinal obstruction, which may lead to subsequent strangulation and perforation of the bowel.PRESENTATION OF CASE: We reported a 1.5 year-old male child presented with intestinal obstruction. Thepatient experienced abdominal pain, vomiting and irritability. Abdominal x-ray showed distal intestinalobstruction which was discovered to be a result of left PDH incidentally during the surgery. In addition,we performed a literature search using PubMed to identify the published cases of PDH. We also comparedour case with the characteristics of all reported PDHs in toddlers and children up to 10 years of age in aconcise table.DISCUSSION: Despite its congenital origin, PDH has been reported in childhood age group in very rareoccasions rendering the accurate incidence of PDH in infancy and childhood unknown. PDHs can beasymptomatic or can present most commonly with recurrent upper abdominal pain. Diagnosis is quitedifficult in the absence of symptoms but could be achieved using a computed tomography (CT-scan) innon-emergency symptomatic patients. Surgical repair is mandatory to avoid potential complications.CONCLUSION: As PDH can lead to major and life threatening complications, it must remain in our mindsas a possible cause of intestinal obstruction.
Paraduodenal hernia , Internal hernia , Left Pediatric , Intestinal obstructiona