Paraduodenal hernia is the most common type of internal hernia, accounting for 53% of reported cases. It represents a rare congenital anomaly which arises from an error of rotation of the midgut. We report a case of right paraduodenal hernia in an 58 year old patient and its emergency diagnosis and management in an acute clinical presentation. A 58 year old male patient was admitted with diffuse abdominal pain, obstipation and vomiting. An abdominal CT scan with intravenous and oral contrast revealed multiple dilated jejunal and proximal ileal loops abutting in C loop of duodenum. It is displacing superior mesenteric vessels anteriorly and there is crowding of mesenteric vessels at the site of abnormal bowel loops. Suggestive of right paraduodenal internal hernia.

The patient underwent a laparotomy, which revealed a large sac containing dilated small bowel loops as shown by radiologic studies. The patient did well in postoperatively and was discharged home on the 5^th day after the surgery.