Left Para duodenal Hernia: Case Report of Rare Cause of Small Bowel Obstruction

Para duodenal hernia [PDH], a rare congenital anomaly, is a type of internal hernia which occurs due to a defect in the reduction and rotation of the midgut. We present the case of a 32-year-old female patient presented with a seven-day history of generalized intermittent colicky abdominal pain accompanied by multiple episodes of bilious vomiting. She was otherwise healthy and had no history of previous abdominal operations. Computed tomography scan of the abdomen demonstrated sac-like clustered small bowel loops noted in the left upper quadrant, in the anterior para-renal space, consistent with the diagnosis of left Para duodenal hernia. Exploratory Laparotomy for the repair of the hernia was planned. The jejunal loops had herniated through the fossa of Waldeyer. Reduction of hernia contents and excision of the hernia sac was carried out. The patient tolerated the procedure without complications, and she was asymptomatic in the follow-up visit. This case sheds light on the importance of considering the diagnosis of left Para duodenal hernia in patients with recurrent abdominal pain, particularly among those who have not undergone abdominal surgery previously.