Diagnosis and treatment of symptomatic right paraduodenal hernia: report of a case

This paper describes a typical case of right paraduodenal hernia (RPH) and briefly reviews the literature on the pathogenesis, diagnosis and treatment of this uncommon pathology. A 32-year-old woman was hospitalized with acute abdominal cramps, nausea and vomiting. RPH was suspected based on CT scans and confirmed by explorative laparoscopy. Repair was performed by open procedure and consisted in the simple suture of the orifice after reducing the hernia. At the 2-year follow up the patient reported complete remission of symptoms. Since RPH is rare and its clinical signs are nonspecific, radiological exams are essential for correct pre-operative diagnosis. CT scan is currently the most accurate diagnostic tool, but laparoscopy may be necessary to confirm the diagnosis. With both the open and the laparoscopic approach, repair can be performed via simple suturing of the hernial orifice, although several authors consider complete intestinal derotation to be the best option.