Right paraduodenal hernia

Case contributed by Dr Domenico Nicoletti


Acute abdomen and vomiting.

Patient Data

Age: 60 years
Gender: Female

In the right hypochondrium, there is abnormal distension of some jejunal loops with air-fluid levels.


The jejunal loops and Treitz are on the right side, near the liver, with "small bowel faeces" sign and hypertrophy of the Kerckring valves; it is associated whirl sign of the mesenteric vessels with modest peritoneal effusion.

The jejunal loops are absent on the left.

Case Discussion

Paraduodenal hernias are a rare type of hernia that results from malrotation of the small intestine during embryonic life. Paraduodenal hernias can arise on the right or on the left.

Clinical manifestations can be variable and non-specific, from asymptomatic, to occlusion and intestinal ischemia. The average age of onset is about 40 years.

In the case, the diagnosis was confirmed surgically.


Operative report

Open laparoscopy

There are parietal adhesions from previous interventions. The omentum moves upward and jeujunal loops are visible at the level of the paraduodenal region.


Right paraduodenal hernia sac with some jeujnal loops with slight ischaemic change. The hernia sac is released and the loops are repositioned through the ligament of Treitz.


Case courtesy Dr.ssa Eleonora Renzi.

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Case information

rID: 58905
Case created: 12th Mar 2018
Last edited: 14th Mar 2018
Inclusion in quiz mode: Included

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