Presentation
History of TAH, a bulge in the left inguinal region.
Patient Data
Anterior abdominal wall defect along the left lateral border of rectus abdominis containing omental fat and bowel loops. Fat strandings are adjacent to hernia likely post-op changes.
A cluster of small bowel loops herniating into left anterior pararenal space, posterior to IMV. No closed loop obstruction noted.
Tiny bilateral renal concretions.
The green arrow represents an inferior mesenteric vein which drains into splenic veins. Small bowel loops pass anterior to IMV but in this case, small bowel loops are passing posteriorly.
Case Discussion
Incidental note of left non obstructed paraduodenal internal hernia in an outdoor patient. Left paraduodenal hernia is the most common type of internal hernia. IMV is a landmark and small bowel loops should cross anteriorly. The patient was discharged and advised follow up as no closed-loop obstruction noted.
"Special thanks and courtesy to Dr Khalid Bin Khursheed for beautifully explaining cross-sectional anatomy of internal hernias."
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