Surgery of left paraduodenal hernia.

The clinical presentation, embryologic and etiologic factors, and repair of left paraduodenal hernia are presented. A new operative procedure for cure of left paraduodenal hernia is presented that deals effectively with the sac and predisposing arch containing the inferior mesenteric vein without section of the vein. Repair is based upon the embryologically normal anatomy with restoration of the inferior mesenteric vein to its normal retroperitoneal position. This procedure has been successfully utilized in a case in which the paraduodenal hernia of small bowel was encountered concomitantly with a perforated duodenal ulcer.