Chen LT, Pan BJ, Lu MD, Wang BH, Zhang N, Hu JW. Paraduodenal hernia with intestinal necrosis: Three case reports and review of literature. World J Gastrointest Surg 2026; 18(7): 120207 [DOI: 10.4240/wjgs.v18.i7.120207]
Corresponding Author of This Article
Jing-Wei Hu, MD, Department of Gastrointestinal Surgery, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, No. 1111 East Section of Wenzhou Avenue, Wenzhou 325000, Zhejiang Province, China. hjwmed@foxmail.com
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Gastroenterology & Hepatology
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case-report
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Chen LT, Pan BJ, Lu MD, Wang BH, Zhang N, Hu JW. Paraduodenal hernia with intestinal necrosis: Three case reports and review of literature. World J Gastrointest Surg 2026; 18(7): 120207 [DOI: 10.4240/wjgs.v18.i7.120207]
World J Gastrointest Surg. Jul 27, 2026; 18(7): 120207 Published online Jul 27, 2026. doi: 10.4240/wjgs.v18.i7.120207
Paraduodenal hernia with intestinal necrosis: Three case reports and review of literature
Li-Tian Chen, Bu-Jian Pan, Ming-Dong Lu, Bo-Hong Wang, Nu Zhang, Jing-Wei Hu
Li-Tian Chen, Department of Surgery, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
Bu-Jian Pan, Ming-Dong Lu, Jing-Wei Hu, Department of Gastrointestinal Surgery, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
Bo-Hong Wang, Nu Zhang, Department of Neurosurgery, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
Author contributions: Chen LT reviewed the literature and contributed to manuscript drafting; Chen LT, Pan BJ, and Hu JW collected patient’s history and performed analysis; Chen LT and Pan BJ analyzed and interpreted the imaging findings; Lu MD, Zhang N, and Wang BH revised the manuscript for important intellectual content. All authors have read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Jing-Wei Hu, MD, Department of Gastrointestinal Surgery, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, No. 1111 East Section of Wenzhou Avenue, Wenzhou 325000, Zhejiang Province, China. hjwmed@foxmail.com
Received: March 3, 2026 Revised: April 6, 2026 Accepted: May 22, 2026 Published online: July 27, 2026 Processing time: 146 Days and 16.7 Hours
Abstract
BACKGROUND
Paraduodenal hernia (PDH) is the most common congenital internal hernia and a rare cause of acute abdominal pain. Its clinical manifestations and signs often mimic common abdominal emergencies, leading to significant challenges in clinical diagnosis and imaging differentiation. This article reports three cases of right PDH (RPDH) and reviews 173 PDH-related articles published in the past 20 years, hoping to assist clinical diagnosis and treatment, minimize misdiagnosis and missed diagnosis, and improve patient outcomes.
CASE SUMMARY
We report three cases of RPDH, including one rare subtype (case 1). The patients were a 42-year-old woman, a 54-year-old man, and an 18-year-old man, all of whom presented to the emergency department with acute abdominal pain as the initial symptom, with varying durations and accompanying symptoms including nausea, vomiting, and diarrhea. Contrastenhanced computed tomography imaging suggested RPDH. Two patients (case 1 and case 3) underwent emergency exploratory laparotomy, while the remaining patient (case 2) initially received conservative treatment but required surgery 11 days later. All the three patients were diagnosed with RPDH intraoperatively and recovered well postoperatively. No recurrent abdominal pain was reported during long-term outpatient follow-up.
CONCLUSION
PDH presents non-specifically as acute abdominal pain; diagnosis relies on contrast computed tomography, and timely surgery is needed for complications.
Core Tip: This report describes three patients with paraduodenal hernia (PDH), including a rare case of right-sided PDH. Contrast-enhanced computed tomography is the preferred imaging modality for diagnosis. Surgical intervention is the definitive treatment for PDH, and exploratory laparotomy is indicated in critical situations. A PubMed search identified 173 articles reporting 197 cases of PDH published over the past 20 years. These cases highlight that PDH should be considered in the differential diagnosis of unexplained acute abdominal pain, and timely imaging evaluation and surgical intervention are key to improving patient outcomes.
