Paraduodenal hernia with intestinal necrosis: Three case reports and review of literature

Figure 4 Epidemiological and clinical characteristics of paraduodenal hernia. A: Paraduodenal hernia (PDH) showed a marked male predominance: 138 male cases vs 58 female cases, with 1 case of unclear gender, consistent with literature reports of male bias; B: Left-sided PDH was most common (n = 146), compared with 50 cases of right-sided PDH and 1 case of indeterminate laterality, reflecting anatomical predisposition to left-sided herniation; C: Highest incidence occurred in middle-aged adults (35-54 years, n = 81), followed by older adults (≥ 55 years, n = 43) and adolescents (13-18 years, n = 19). Cases were rare in infants and young children, suggesting a link to age-related abdominal changes or chronic intra-abdominal pressure; D: Cross-sectional imaging (computed tomography/multi-detector computed tomography/contrast-enhanced computed tomography, n = 167) was the most frequent preoperative diagnostic tool, followed by intraoperative confirmation (n = 124). Less common methods included barium contrast studies, magnetic resonance imaging, laparoscopy, and paracentesis, highlighting computed tomography’s central role in PDH diagnosis. PDH: Paraduodenal hernia; NR: Not reported; CT: Computed tomography; MDCT: Multi-detector computed tomography; CECT: Contrast-enhanced computed tomography; MRI: Magnetic resonance imaging.