Paraduodenal Hernia - Abnormal Treitz Ligament

Paraduodenal hernia, a rare congenital anomaly which arises from an error of rotation of the midgut, is the most common type of intra-abdominal hernia. There are two variants, right and left paraduodenal hernia. The term paraduodenal hernia refers to a hernia of the entire small bowel, or part of it, into a sac derived from folds of peritoneum and fossae normally found at the terminal or 4th portion of the duodenum. We report our experience in the diagnosis and management of a young male presented acutely with a 3 day history of vomiting and absolute constipation. Intestinal obstruction was diagnosed following an abdominal x ray. Correct preoperative diagnosis of Right paraduodenal hernia had been difficult due to non-specific clinical presentations. Due to the risk of obstruction and strangulation, surgical treatment is indicated, however, timely intervention increases the likelihood of a favorable outcome.