Laparoscopic Ladd's procedure for the repair of a right paraduodenal hernia in pediatric patients - A case series
Introduction: Right paraduodenal hernias are a consequence of midgut malrotation resulting in small bowel encased in a peritoneal-lined hernia sac posterior to the right mesocolon. An indistinct presentation often lends a difficult clinical diagnosis and identification on diagnostic laparoscopy; how...
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| Main Authors: | , , , , , |
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| Format: | Book |
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Elsevier,
2023-08-01T00:00:00Z.
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| Summary: | Introduction: Right paraduodenal hernias are a consequence of midgut malrotation resulting in small bowel encased in a peritoneal-lined hernia sac posterior to the right mesocolon. An indistinct presentation often lends a difficult clinical diagnosis and identification on diagnostic laparoscopy; however, when identified, surgical repair should ensue due to a significant lifetime risk of small bowel incarceration. Case presentations: Two female adolescents (ages 12 and 16-years-old) were referred to Pediatric Surgery clinic for intermittent abdominal pain and frequent emesis with radiographic and endoscopic findings consistent with intestinal malrotation. Patients underwent diagnostic laparoscopy at which time a right paraduodenal hernia was identified. Repair was performed via a laparoscopic hernia reduction and laparoscopic Ladd's procedure with appendectomy. Procedure time was 96-206 minutes. There were no intraoperative or postoperative complications to date. Both patients reported near to complete resolution of abdominal pain and emesis. Conclusion: Laparoscopic paraduodenal hernia reduction and Ladd's procedure with appendectomy is a novel, minimally invasive approach to the repair of right paraduodenal hernia in children. |
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| Item Description: | 2213-5766 10.1016/j.epsc.2023.102668 |