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This case report presents a unique clinical presentation of small bowel obstruction secondary to congenital partial malrotation of the gut in adults. Partial malrotation may have variable clinical presentations and this case highlights a constellation of patient history, radiographic signs, and operative findings leading to appropriate diagnosis and successful surgical management. A 56-year-old female patient presented with severe abdominal pain, nausea, and anorexia.

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Internal hernias, including Left para duodenal Hernias (LPDH), are rare and challenging to diagnose due to their nonspecific symptoms and complex anatomical presentation. This report presents a unique case of a 29-year-old female with preoperatively diagnosed uncomplicated LPDH, complicated by distal bowel ischemia-a manifestation not extensively documented in existing literature. Initial imaging revealed dilated jejunal loops indicative of LPDH, with subsequent contrast-enhanced computed tomography (CECT) showing ischemic changes in bowel segments distal to the hernia.

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Paraduodenal hernias are rare internal hernias in which the small intestine becomes trapped behind the mesentery of the colon. These hernias can lead to bowel obstruction and ischaemia, making early diagnosis and intervention crucial. Patients often exhibit non-specific symptoms, highlighting the importance of using CT imaging for diagnosis.

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Article Synopsis
  • - Para-duodenal hernias account for 53% of internal hernias, mostly occurring on the left side, with rare symptoms in adults and a higher prevalence in males; right para-duodenal hernias are particularly uncommon and often discovered during emergency surgeries.
  • - A 71-year-old male experienced severe abdominal pain, nausea, and vomiting, leading to a CT scan that identified a right para-duodenal hernia, resulting in an emergency surgery where the hernia was confirmed.
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