Two Cases of Paracecal Hernia

Jun Ohishi, Shingo Yoshioka, Takanobu Maki and Akira Tomita

Department of Surgery, Itoshima Medical Association Hospital

We treated 2 cases of paracecal hernia surgically based on preoperatively diagnosis. Case 1: An 89-year-old woman hospitalized for congestive heart failure experienced abdominal pain and vomiting, with spontaneous pain and tenderness in the right lower abdomen. She was diagnosed with ileus based on abdominal X-ray. Abdominal CT showed radical distribution in the paracecal region. Ileus due to paracecal hernia was suspected, necessitating emergency surgery. Case 2: A 59-year-old man transferred to our hospital on suspiction of ileus due to small bowel volvulus had spontaneous pain and tenderness in the right lower abdomen. Abdominal CT showed incarcerated intestines on the right side of the retroperitoneum and ascites and US showed involvement of the small intestine into the retrocecum. Based on a preoperative diagnosis of retrocecal hernia, we conducted emergency surgery. Paracecal hernia is rare, with unpredictable symptoms that make it difficult to diagnose preoperatinely. In most cases, there were some abnormal findings in the right lower abdomen, such as spontaneous pain, tenderness, or palpitation of a mass lesion. Reports of preoperative diagnosis of this disease by abdominal CT have increased. Physical findings of the right lower abdomen and findings in abdominal CT and US must thus be kept in mind for early treatment.

Key words
paracecal hernia, retrocecal hernia, internal hernia

Reprint requests
Akira Tomita Department of Surgery, Itoshima Medical Association Hospital
1-532 Urashi, Maebaru City, 891-1112 JAPAN

Accepted
June 30, 2004

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