Paraduodenal hernia presenting as unexplained recurrent abdominal pain

We present a case of a 29-yr-old female nurse who presented with an 8-h his tory of abdominal pain. She had had similar episodes (twice/yr) over the la st 5 yr, and the pain had usually resolved spontaneously. Prior investigati ons including laboratory studies, plain films of the abdomen, an abdominal and pelvic ultrasound, and a CT scan yielded no diagnosis. Her pain was pre viously considered to be either psychosomatic or a variant of irritable bow el syndrome. On this admission, an evaluation and subsequent enteroclysis r evealed a left paraduodenal hernia. The importance of considering paraduode nal hernias in the differential diagnosis of unexplained intermittent abdom inal pain is discussed here. (Am J Gastroenterol 1999;94:3614-3615. (C) 199 9 by Am. Coll. of Gastroenterology).