Intestinal obstruction secondary to right paraduodenal hernia in the context of intestinal malrotation is rare.
A 53-year-old male patient presented with abdominal pain and distension. Abdominal computed tomography showed: intestinal obstruction due to a complicated right paraduodenal hernia; ‘whirlpool sign’ and displacement of the mesentery towards the right flank (**); blockage of dilated small intestine loops displaced to the right of the duodenum (arrow) (Fig. 1).
Exploratory laparotomy confirmed: incarcerated right paraduodenal hernia in a patient with intestinal malrotation; angle of Treitz (T) in the right abdomen, caudal to the ileocecal valve (V); cecum (C) and terminal ileum in the right hypochondrium; redundant mesoappendix in continuation with the mesentery of the first jejunal portion, creating a cul-de-sac (Fig. 2).
Treatment is surgical and involves reducing the hernial content and avoiding new episodes, either by closing or widening the defect.
