Although left paraduodenal hernia is the most prevalent form of internal hernia, it is responsible for fewer than 6% of intestinal obstruction cases. Its nonspecific early clinical manifestations, among which are intermittent abdominal pain, bloating, or vomiting, often make preoperative diagnosis challenging. We report the case of a young male who developed an acute closed-loop intestinal obstruction following high-intensity exercise, which was ultimately attributed to a congenital left paraduodenal hernia caused by failure of fusion of the left colonic mesentery. This case clearly illustrates the rapid progression from nonspecific abdominal pain to acute intestinal obstruction. Initially, the abdominal pain of the patient resolved with rest, but later progressed to persistent colicky pain accompanied by vomiting, suggestive of complete obstruction. Emergency surgical exploration confirmed the etiology, and the patient was successfully managed with a combination of early enteral and parenteral nutrition postoperatively. Timely surgical intervention proved crucial in preventing serious complications such as peritonitis and sepsis.
Wu et al. (Tue,) studied this question.