Abstract
An: 2015, Nr.4, Articol Nr. 3
Title: 

PARADUODENAL FOSSAE – DEVELOPMENT AND CLINICAL IMPLICATIONS

Authors: 

      B.I. Diaconescu, B.M. Cristea, Laura Stroica, Al.G. Lupu, M.R. Bratu, Al.Th. Gheorghe, G. Lupu - University of Medicine and Pharmacy “Carol Davila”, Bucharest, Anatomy Department
      Adelina M. Sorescu, C.G. Bulzan - University of Medicine and Pharmacy “Carol Davila”, Bucharest, Student
      PARADUODENAL FOSSAE – DEVELOPMENT AND CLINICAL IMPLICATIONS (Abstract): Internal hernias constitute a rare etiology of intestinal obstructions (approximately 0.2-0.8%). A subtype of this condition, the paraduodenal hernias (PDH), comprise the protrusion of intestinal loops into a series of peritoneal recesses. These are developed by the peritoneum which circumvents the duodenum (especially the ascending one and the duodenojejunal flexure). Ever since the first PDH properly diagnosed by Kummer in 1921, there has been a high risk of overlooking such diseases, due to the non-specific clinical presentation and paraclinical examinations. Materials and methods: Consequently to studying the literature, with the help of anatomical dissection on cadavers from the Anatomy Department we were able to highlight the local anatomy and we had the ability of photographing the major vascular elements and viscera. Our study was completed by analizing a series of intra-operatory photographs.Results: Similar to what we have expected, we had the chance to observe the presence of paraduodenal folds and fossae. We wanted to emphasize the elements that form these peritoneal recesses (mainly the left colic artery and the inferior mesenteric vein) and the manner the fossae open into the peritoneal cavity. Last but not least, we found a close relantionship between the superior mesenteric artery and the mesentericoparietal fossa of Waldeyer. Conclusions: We consider that the benefit of this study is to familiarize physicians and surgeons with the local anatomy and to show how simple it is to overlook PDH as an inducer of intestinal obstructions, especially in a neonatal or pediatric patient.
Key words: FOLDS, RECESS, PERITONEUM, HERNIA, VOLVULUS
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