TITLE: EMERGENCY MANAGEMENT OF SMALL BOWEL OBSTRUCTION DUE TO PARADUODENAL HERNIA IN A PATIENT WITH COVID-19: A CASE REPORT
Rachel Schneider*, James E Carroll, Armando Salim Munoz Abraham, Donald R. Czerniach
University of Massachusetts Chan Medical School, Worcester, MA
ABSTRACT: In this case report we present the emergency surgical management of a 75 year old COVID-19 positive male patient who presented to the emergency department with lower abdominal pain and was found on exploratory laparotomy to have a small bowel obstruction due to left-sided paraduodenal hernia. Up to 2% of the population has an existing paraduodenal hernia, and strangulated paraduodenal hernias have a mortality rate of 50% when left untreated, which underlies the need for comprehensive data on surgical management of paraduodenal hernias.1 Existing literature only describes the management of 159 patients with paraduodenal hernias, and in addition, many paraduodenal hernias which have been described were identified by abdominal CT scan and managed with laparoscopic surgeries unlike our patient. In this paper we describe the successful management of our patient, summarize existing literature on the management of paraduodenal hernias, and comment on the potential associations between COVID-19 and bowel obstructions secondary to hernias.
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