Left Paraduodenal Hernia Presenting as Intestinal Obstruction: Report of One Case

腸阻塞的病因包括粘黏，腫瘤，狹窄，腸套疊，扭結，及疝氣等。在小腸疝氣方面，除常見的腹壁疝氣及腹股溝疝氣之外，我們也不能忽略爲數較少的小腸腹內疝氣。小腸腹內疝氣可分爲先天性及後天性，後天性的小腸腹內疝氣大都是起因於先前的腹部創傷或手術；先天性小腸腹內疝氣則包括多種類型，其中較多的兩種是網膜疝氣及十二指腸旁疝氣。十二指腸旁疝氣雙稱爲腸繁膜繁疝氣，即小腸由腸纛膜缺陷移位到後腹腔，其又可分爲和左側和右側疝氣。我們報告一個十三歲大男性，病局以部腸阻塞的症狀表現，影像上顯示左側腫塊般病竈灶及被此病灶推向右側的降結腸。開刀結果證實是較爲罕見的小腸腹內疝氣，類型是左側十二腸旁疝氣。因此，對於懷疑腸阻塞之病例，應將小腸腹內疝氣列入鑑別診斷之攷慮項目。

關鍵字

腸阻塞；腹內疝氣；十二指腸旁疝氣

並列摘要

We report a case of internal hernia of the small intestine in a 13-year-old boy with presentation of partial intestinal obstruction. The patient suffered from recurrent abdominal pain and chronic constipation over the past few years. An abdominal mass was suspected from clinical manifestations and images derived from abdominal echography. Upper gastrointestinal contrast study revealed poor motility at the distal jejunum with barium stasis. Follow-up film on the next day delineated medially and downwardly displaced splenic flexure and proximal descending colon. At operation, total herniation of small intestine into a retroperitoneal space through a defect on left mesocolon was noted. A left paraduodenal (mesocolic) hernia was diagnosed. The patient made an uneventful recovery after the hernia was repaired. This report provides unusual image clues of internal hernias of the small intestine presenting as ileus. Though rare, paraduodenal hernia should be taken into account in a differential diagnosis of intestinal obstruction. Early surgical intervention allows uneventful recovery to occur and also prevents the possible complication of gangrenous bowels.

並列關鍵字

internal hernia ； intestinal obstruction ； paraduodenal hernia

國際替代計量

Left Paraduodenal Hernia Presenting as Intestinal Obstruction: Report of One Case

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