Laparoscopic correction of hydronephrosis caused by left paraduodenal hernia in a child with cryptorchism: A case report

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Abstract

BACKGROUND

Paraduodenal hernia (PDH) is a mesenteric-parietal hernia with retroperitoneal and retrocolic herniation of the small bowel into a sac, which is formed by a peritoneal fold located near the fourth portion of the duodenum. The present case revealed that PDH was a possible reason for hydronephrosis, and that the carful laparoscopic exploration surgery was necessary to find infrequent causes of hydronephrosis to avoid invalid Anderson–Hynes pyeloplasty surgery and its injury.

CASE SUMMARY

An 8-year-old boy presented to the pediatric department with a chief complaint of cryptorchidism. Afterwards, laparoscopy confirmed hydronephrosis secondary to left PDH with cryptorchid. Then, he received laparoscopic surgery, fixed operation for left PDH, release of the ureteropelvic junction obstruction, and treatment for hydronephrosis. It is necessary to perform secondary surgery for cryptorchidism and long-term follow-up.

CONCLUSION

The case revealed an extremely rare cause of hydronephrosis in children, suggesting a potential correlation between PDH and hydronephrosis.

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Most cited references 29

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Laparoscopic repair of a paraduodenal hernia.

H Oguri, M Iwase, T Nakamuka … (1997)

Paraduodenal hernias have traditionally been treated by conventional laparotomy. We report the first case of a left paraduodenal hernia treated laparoscopically. A 44-year-old man was admitted with abdominal pain and nausea. Computed tomography and an upper gastrointestinal series with small-bowel followthrough showed accumulation of the small bowel on the left side of the abdomen. A laparoscopic repair was performed. The small bowel was observed beneath a thin hernia capsule. Approximately 1.5 m of jejunum was easily reduced into the abdominal cavity. The hernia orifice (5-cm diameter) was closed intracorporeally with five interrupted sutures. Good exposure of the operative field is critical to this procedure; poor exposure may limit the applicability of the laparoscopic approach. This minimally invasive operation is currently indicated in nonobstructive paraduodenal hernias, especially on the left.

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Laparoscopic management of paraduodenal hernias: mesh and mesh-less repairs. A report of four cases.

N N Anand, M. Rangarajan, C Palanivelu … (2008)

Paraduodenal hernias are the most common form of internal hernias. There are few reports in the literature, with the total number of reported cases being less than 500. We report four patients with paraduodenal hernias causing intestinal obstruction. All of the four patients with paraduodenal hernias presented with features of intestinal obstruction. A clinical diagnosis was not made in any of the cases, and computed tomography (CT) scanning was performed to confirm this. They were all successfully managed by a laparoscopic repair. The operating time was 55-72 mins. Postoperatively, three patients recovered uneventfully, while one patient had ileus for 3 days and, thereafter, recovered spontaneously. Hospital stay was in the range 2-6 days. There were no conversions. One patient had recurrent paraduodenal hernia, for which a laparoscopic mesh repair was successfully performed. The mechanism of the herniation is thought to be a defective rotation of the superior mesenteric vein during embryonic development. Paraduodenal hernias are not high on the list of differentials for bowel obstruction. Some form of surgery is mandatory for all cases. The inferior mesenteric vein has to be sacrificed in some cases to facilitate reduction of the hernia contents. A mesh repair is reserved for large defects and recurrent hernias. Laparoscopic repair has been infrequently reported in the literature. Based on our experience, the laparoscopic approach seems to be effective in the repair of paraduodenal hernias. It carries all of the benefits of minimal access surgery, while providing a sound repair.

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Laparoscopic management of left paraduodenal hernia

B P S Parmar, R. S. Parmar (2010)

Internal herniation of small bowel accounts for about 1% of all the patients with intestinal obstruction. Fifty percent of the patients with paraduodenal hernia will have bowel obstruction. Left paraduodenal hernia resulting from abnormal rotation of the midgut during embryonic development is the most common form of congenital internal hernia. A case of a young male presenting with chronic abdominal pain due to left paraduodenal hernia is being reported. A correct preoperative diagnosis of left paraduodenal hernia was made on computerised tomography (CT), and the patient was managed by laparoscopic surgery. The role of imaging in preoperative diagnosis is being highlighted with a brief review of literature.

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Author and article information

Contributors

Xin Wang

Yong Wu

Yong Guan

Journal

Journal ID (nlm-ta): World J Clin Cases

Journal ID (publisher-id): WJCC

Title: World Journal of Clinical Cases

Publisher: Baishideng Publishing Group Inc

ISSN (Electronic): 2307-8960

Publication date (Print): 26 September 2022

Publication date (Electronic): 26 September 2022

Volume: 10

Issue: 27

Pages: 9814-9820

Affiliations

Department of Pediatric Surgery, Tianjin Children's Hospital, Tianjin 300014, China

Department of Pediatric Surgery, Tianjin Children's Hospital, Tianjin 300014, China. guan_lab@ 123456126.com

Author notes

Author contributions: Guan Y wrote this manuscript; Wang X analyzed the data; Wang X, Wu Y, and Guan Y took care of the patient and collected the data; all authors read and approved the final manuscript; Wang X and Guan Y contributed equally to this work.

Corresponding author: Yong Guan, MD, Chief Doctor, Department of Pediatric Surgery, Tianjin Children's Hospital, No. 238 LongYan Road, Tianjin 300134, China. guan_lab@ 123456126.com

Article

Other ID: jWJCC.v10.i27.pg9814

DOI: 10.12998/wjcc.v10.i27.9814

PMC ID: 9516897

SO-VID: 791bad27-c69b-40e4-a03b-c4dab9d9a8f7

License:

This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/

History

Date received : 23 April 2022

Date revision received : 3 July 2022

Date accepted : 15 August 2022

Laparoscopic correction of hydronephrosis caused by left paraduodenal hernia in a child with cryptorchism: A case report

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Abstract

BACKGROUND

CASE SUMMARY

CONCLUSION

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Most cited references 29

Laparoscopic repair of a paraduodenal hernia.

Laparoscopic management of paraduodenal hernias: mesh and mesh-less repairs. A report of four cases.

Laparoscopic management of left paraduodenal hernia

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