Small bowel obstruction caused by transmesosigmoid internal hernia

Authors

  • Ata M. Ghaith Department of Surgery, Al-Balqa Applied University, Al-Salt New Hospital, Al-Salt, Jordan
  • Ahmad A. Al-Kharabsheh Department of Surgery, Ministry Health of Jordan, Al-alt New Hospital, Al-Salt, Jordan
  • Mohammad I. Al-Sakarneh Department of Surgery, Ministry Health of Jordan, Al-alt New Hospital, Al-Salt, Jordan
  • Osama M. Ghaith Department of Surgery, Ministry Health of Jordan, Al-alt New Hospital, Al-Salt, Jordan

DOI:

https://doi.org/10.18203/2349-2902.isj20240756

Keywords:

Small bowl obstruction, Internal hernia, Sigmoid related hernia, Transmesosigmoid internal hernia.

Abstract

Internal hernia is an uncommon occurrence contributing to intestinal obstruction, posing diagnostic challenges. Among the infrequent manifestations, one noteworthy type is associated with the sigmoid colon, categorized into three subtypes: inter-sigmoid, trans-mesosigmoid, and intra-mesosigmoid. We present a case of a 48-year-old female who presented with small bowel obstruction as an emergency. CT showed intestinal obstruction with translational point at mid jejunum without any mass identified. At laparotomy we identified an internal hernia in the sigmoid mesocolon with full thickness mesentery defect (transmesosigmoid), bowel was viable and reduced where the defected was closed. Early identification of internal hernia and early management prevent mortality and morbidity; sigmoid related hernia is rear type of internal hernia. Most internal hernia diagnosed during laparotomy searching for case of acute intestinal obstruction.

References

Ghiassi S, Nguyen SQ, Divino CM, Byrn JC, Schlager A. Internal hernias: clinical findings, management, and outcomes in 49 non-bariatric cases. J Gastrointest Surg. 2007;11(3):291-5.

Hirashima K, Date K, Fujita K, Koide N, Kamuro A, Kato H et al. Strangulation of the small intestine caused by an intra-mesosigmoid hernia: a case report. Surg Case Rep. 2017;3(1):129.

Agarwal A, Ray U, Hossain MZ, Nilanjan M, Amitabha D, Anshu A, et al. Congenital intra-mesosigmoid hernia-a case report of a rare sigmoid mesocolon hernia. Indian J Surg. 2011;73(6):450-2.

Li B, Assaf A, Gong YG, Feng LZ, Zheng XY, Wu CN. Trans-mesosigmoid hernia: case report and review of literature. World J Gastroenterol. 2014;20(19):5924-9.

Doishita S, Takeshita T, Uchima Y, Masayasu K, Taro S, Akiyoshi Y, et al. Internal hernias in the era of multidetector CT: correlation of imaging and surgical findings. Radiographics. 2016;36(1):88-106.

Lanzetta MM, Masserelli A, Addeo G, Diletta C, Nicola M, Ginevra D, et al. Internal hernias: a difficult diagnostic challenge. Review of CT signs and clinical findings. Acta Biomed. 2019;90(5-S):20-37.

Lukman K, Setya Sulthana BAA, Andreas R, Nugraha P. Hernia: a case report. Ann Med Surg (Lond). 2023;85(5):2115-8.

Benson JR, Killen DA. Internal hernias involving the sigmoid mesocolon. Ann Surg. 1964;159:382.

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Published

2024-03-27

Issue

Section

Case Reports