Presentation
Abdominal pain for 2-3 months. No vomiting.
Patient Data
Cluster of non-dilated jejunal loops in left upper quadrant (anterior to the left kidney) causing mild mass effect in the form of anterosuperior displacement of distal body and tail of the pancreas. These features are consistent with a left paraduodenal hernia.
Inferior mesenteric vein passing anteromedial to the hernia.
No features of intestinal obstruction.
Case Discussion
Left paraduodenal hernia is the most common type of internal hernia, occurring through the congenital defect (fossa of Landzert). It is characterized by the presence of a cluster of small bowel loops in left anterior pararenal space with or without mass effect on surrounding structures.
The inferior mesenteric vein is usually seen adjacent to the neck of the hernial sac.
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