Laparoscopic Management of a Rare Right Paraduodenal Hernia: A Case Report Highlighting Successful Minimally Invasive Intervention

Abstract Paraduodenal hernias are a rare type of internal hernia, typically diagnosed in middle-aged adults and uncommon in younger patients. Left paraduodenal hernias account for approximately 75% of cases, while right paraduodenal hernias account for only 25%. These hernias occur when a portion of the jejunum herniates through the posterior portion of the ligament of Treitz. Preoperative diagnosis is challenging; however, if not managed appropriately, mortality rates can be high. A 30-year-old female presented to the emergency department with progressively worsening abdominal pain, nausea, and vomiting over 6 h. The patient had no significant medical or surgical history. Physical examination revealed abdominal tenderness, abdominal distension, and no signs of peritonitis. Laboratory investigations indicated elevated inflammatory markers (white blood cell count: [X] cells/μL, C-reactive protein: [X] mg/dL). Computed tomography (CT) revealed an internal hernia with evidence of small bowel obstruction. After discussing treatment options with the patient, diagnostic laparoscopy was performed. Intraoperatively, the hernia sac was found on the right side of Treitz’s ligament. The hernia was successfully reduced, and the mesenteric defect was repaired using sutures. The patient tolerated the procedure well, resumed oral feeding 24 h postoperatively, and was discharged on the fourth postoperative day. A one-year follow-up CT scan showed normal findings. This case report highlights the successful laparoscopic management of a rare right paraduodenal hernia in a young patient. Early recognition, accurate diagnosis through imaging, and timely surgical intervention are crucial for optimal outcomes. Further studies are needed to evaluate the long-term outcomes and benefits of the laparoscopic approach in such cases.