Patient was planned for emergency surgical exploration after all
preoperative investigations. A midline incision was given, and
exploration was done, which showed evidence of a 2.5cm defect in the
mesentery near the fourth part of the duodenum, left paraduodenal hernia
was seen through the mesentery with herniation of jejunal loops, and
herniated loops were viable with active peristalsis seen. Constriction
ring evident at 40 cm from Duodenojejunal flexure on jejunum, the ring
formed at the site of rent in the mesentery [Figure
2-4].
Figure 2: 2.5 cm defect in mesentry near 4 th part of
duodenum where jejunum is herniating (shown by arrow).