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Left paraduodenal hernia accompanying chylous ascites.

Yu DY, Jang YJ, Mok YJ - Ann Surg Treat Res (2015)

Bottom Line: As soon as the peritoneum was exposed, 1.5 L of chylous fluid was found.A hernial sac was found along the posterior side of the mesentery of the inferior mesenteric artery.On the sixth day after the surgery, she was discharged without any complication.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.

ABSTRACT
Paraduodenal hernia is by far the most common form of congenital internal hernia. Chylous ascites is an accumulation of lymphatic fluid in the peritoneal cavity. It develops when the lymphatic system is disrupted due to traumatic injury or obstruction. A 40-year-old, woman showed up to the Emergency Department with severe, colicky abdominal pain. Tenderness and rebound tenderness were observed at the left abdomen. Abdominal CT confirmed a cluster of dilated proximal small bowel loops with ischemic change, without ascites. The patient underwent an emergency surgery to relieve bowel ischemia. As soon as the peritoneum was exposed, 1.5 L of chylous fluid was found. A hernial sac was found along the posterior side of the mesentery of the inferior mesenteric artery. We resected the hernial sac and pulled out the herniated small bowel. On the sixth day after the surgery, she was discharged without any complication.

No MeSH data available.


Related in: MedlinePlus

(A, B) The patient's abdomen CT-scan. There seems a hernial sac wrapping small bowel and hernia root is observed. There is mild ischemic change on herniated small bowel in comparison with the other segment of small bowel.
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Figure 1: (A, B) The patient's abdomen CT-scan. There seems a hernial sac wrapping small bowel and hernia root is observed. There is mild ischemic change on herniated small bowel in comparison with the other segment of small bowel.

Mentions: A 40-year-old, previously healthy woman presented to the Emergency Department with severe, colicky abdominal pain. The pain started 2 hours before her visit, with a numeric rating scale score of 10 out of 10. It intermittently recurred and radiated to the back. It was not related to food intake and not associated with fever, chilling, nausea, vomiting, and diarrhea. It was her first time to experience such a pain. After intravenous administration of analgesics, the pain subsided. On physical examination, her bowel sound was normoactive, and her abdomen was soft and flat. Tenderness and rebound tenderness were observed at the left upper and lower quadrants of the abdomen. In the initial laboratory test, no abnormal results and evidence of inflammation were found, with a white blood cell count of 4,000 × 103/µL and neutrophil level of 52%. An abdominal film did not reveal any evidence of bowel obstruction. Abdominal CT confirmed a cluster of dilated proximal small bowel loops with ischemic change, without ascites (Fig. 1).


Left paraduodenal hernia accompanying chylous ascites.

Yu DY, Jang YJ, Mok YJ - Ann Surg Treat Res (2015)

(A, B) The patient's abdomen CT-scan. There seems a hernial sac wrapping small bowel and hernia root is observed. There is mild ischemic change on herniated small bowel in comparison with the other segment of small bowel.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4644909&req=5

Figure 1: (A, B) The patient's abdomen CT-scan. There seems a hernial sac wrapping small bowel and hernia root is observed. There is mild ischemic change on herniated small bowel in comparison with the other segment of small bowel.
Mentions: A 40-year-old, previously healthy woman presented to the Emergency Department with severe, colicky abdominal pain. The pain started 2 hours before her visit, with a numeric rating scale score of 10 out of 10. It intermittently recurred and radiated to the back. It was not related to food intake and not associated with fever, chilling, nausea, vomiting, and diarrhea. It was her first time to experience such a pain. After intravenous administration of analgesics, the pain subsided. On physical examination, her bowel sound was normoactive, and her abdomen was soft and flat. Tenderness and rebound tenderness were observed at the left upper and lower quadrants of the abdomen. In the initial laboratory test, no abnormal results and evidence of inflammation were found, with a white blood cell count of 4,000 × 103/µL and neutrophil level of 52%. An abdominal film did not reveal any evidence of bowel obstruction. Abdominal CT confirmed a cluster of dilated proximal small bowel loops with ischemic change, without ascites (Fig. 1).

Bottom Line: As soon as the peritoneum was exposed, 1.5 L of chylous fluid was found.A hernial sac was found along the posterior side of the mesentery of the inferior mesenteric artery.On the sixth day after the surgery, she was discharged without any complication.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.

ABSTRACT
Paraduodenal hernia is by far the most common form of congenital internal hernia. Chylous ascites is an accumulation of lymphatic fluid in the peritoneal cavity. It develops when the lymphatic system is disrupted due to traumatic injury or obstruction. A 40-year-old, woman showed up to the Emergency Department with severe, colicky abdominal pain. Tenderness and rebound tenderness were observed at the left abdomen. Abdominal CT confirmed a cluster of dilated proximal small bowel loops with ischemic change, without ascites. The patient underwent an emergency surgery to relieve bowel ischemia. As soon as the peritoneum was exposed, 1.5 L of chylous fluid was found. A hernial sac was found along the posterior side of the mesentery of the inferior mesenteric artery. We resected the hernial sac and pulled out the herniated small bowel. On the sixth day after the surgery, she was discharged without any complication.

No MeSH data available.


Related in: MedlinePlus