PMC8007996_01
Supine anterior-posterior radiograph of the abdomen, demonstrating a well-circumscribed mass (arrow) projected in the left upper quadrant of the abdomen, representing the left paraduodenal hernia.
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The supine plain radiograph of the abdomen (Figure 1) demonstrated a well-circumscribed mass projected in the left upper quadrant of the abdomen.
(a) Axial and (b) sagittal portal venous imaging of the abdomen, demonstrating jejunal loops within the left paraduodenal hernia (black arrow) and stretched mesenteric vessels (white arrow) entering the hernial sac. Dilatation of the proximal duodenum (star) is seen with non-visualisation of a normal duodenal jejunal flexure. Note the position of the left paraduodenal hernia, approximating the posterior margin of the stomach.
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Multiphase contrasted CT imaging was performed with prior administration of oral contrast (Figure 2).
(a) Axial portal venous phase and (b) sagittal reformatted maximum intensity projection images demonstrating the left paraduodenal hernia in relation to the vascular landmarks. Ascending branch of the left colic artery (white arrow) noted on the axial portal venous phase and sagittal reformatted maximum intensity projection image, as well as the inferior mesenteric vein (black arrow) on the axial portal venous phase, approximating the anterior margin of the left paraduodenal hernia.
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The inferior mesenteric vein and the ascending branch of the left colic artery were seen along the anterior margin of the hernial sac (Figure 3).
Intraoperative findings demonstrating the congenital defect, fossa of Landzert and the left paraduodenal hernia.
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Intraoperative findings (Figure 4) confirmed the congenital defect (white arrow), presence of fossa of Landzert, and jejunal bowel loops within the left PDH.