Left paraduodenal hernia causing acute small bowel obstruction

Paraduodenal hernias are rare fascinating variety of hernias that arise in the potential spaces and folds of the posterior parietal peritoneum adjacent to the ligament of Treitz. These may present with chronic intermittent abdominal pain, acute small bowel obstruction or bowel ischaemia. Treatment is by surgery. We present a case of a 32-year-old male who had previously presented to us on multiple occasions with abdominal pain that had always relieved by its own. Only this time he presented with acute intestinal obstruction. The anatomy, management and significance of considering this uncommon diagnosis while examining a patient with acute small bowel obstruction are discussed.