DISCUSSION:
When a paraduodenal hernia is discovered, surgery should be performed to
treat it since there is a 50% lifetime chance of incarceration, which
can result in bowel obstruction and strangling (4,6). Both minimally
invasive laparoscopic procedures and traditional open approaches can be
used to treat patients. Reduction of the entrapped intestinal loops,
with resection, if necessary in the case of nonviable segments, and
repair of the defect by either widening or closing the hernia orifice to
allow the hernia sac to become a part of the general peritoneal cavity
constitute the standard surgical approach for posterior superior hernias
(2, 7-10). Usually, it is easy to diminish left PDH. Sutures are
adequate to close the hernia opening. If reduction proves problematic,
the hernia aperture is widened by dividing the IMV or making an incision
along the descending mesocolon’s avascular plane (2). Hernia sac
excision is usually not required. A mesh can be used to remedy recurrent
situations (3). In this instance, there was no need for IMV
scarification or hernia sac expansion because the left PDH was readily
minimized. It was sufficient to close the hernia orifice in its primary
form.