scholarly journals Transmesocolon internal hernia masking as simple sigmoid volvulus

2020 ◽  
Vol 2020 (3) ◽  
Author(s):  
Han N Beh ◽  
Yuni F Ongso ◽  
David B Koong
Keyword(s):  
Small Bowel ◽  
Bowel Obstruction ◽  
Internal Hernia ◽  
Large Bowel ◽  
Sigmoid Volvulus ◽  
Emergency Laparotomy ◽  
Transverse Mesocolon ◽  
Hartmann Procedure ◽  
Internal Hernias ◽  
Colonic Decompression

Abstract Transmesocolon internal hernias are very rare causes of bowel obstruction. Transmesenteric internal hernias normally associated with small bowel. It can be challenging to diagnose transmesocolon internal hernia hence we present a 93-year-old patient who was misdiagnosed with simple sigmoid volvulus on CT abdomen. She underwent endoscopic colonic decompression. Patient continued to deteriorate in the ward, and CT abdomen was repeated; it revealed the cause of the sigmoid volvulus was due to a defect through transverse mesocolon resulting in internal hernia. Patient was diagnosed with transmesocolic internal hernia with sigmoid volvulus. Patient underwent emergency laparotomy and Hartmann procedure. Transmesocolic internal hernia can be easily missed and needs to be considered when diagnosing patients with large bowel volvulus or obstruction.

scholarly journals Internal hernia through dual defects: defects in transverse mesocolon and lesser omentum a rare presentation: case report

2021 ◽  
Vol 9 (1) ◽  
pp. 236
Author(s):  
Venu Bharagava Malpuri ◽  
Prasanth Gurijala ◽  
Bhaskar Reddy Yerrola ◽  
Krishna Ramavath ◽  
Gopisingh Lavudya
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Internal Hernia ◽  
Morbidity And Mortality ◽  
Transverse Mesocolon ◽  
Hernia Sac ◽  
Internal Hernias ◽  
Contrast Enhanced Ct ◽  
Asymptomatic Patients

Internal hernias have the potential to cause small bowel obstruction. Congenital internal hernias are impossible to diagnose clinically and radiologically in asymptomatic patients. We presented a case of 36 years male with complaints of pain abdomen abdominal distension and vomiting, contrast-enhanced CT showed an internal hernia with small bowel obstruction. On exploration, small bowel loops were identified near the lesser curvature and they are congested an edema was present, a defect of 5×1 cm was identified in the transverse mesocolon and was managed by reducing the hernia sac and closure of the defect in the mesentery of the transverse colon. If the intervention was delayed internal hernia might lead to ischemia, gangrene increasing morbidity and mortality. Early intervention is the key to decrease morbidity and mortality. 

scholarly journals Case Report: Right paraduodenal hernia – a unique case of rare internal hernia presenting as acute small bowel obstruction

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 1282
Author(s):  
Brikha Raj Joshi ◽  
Swotantra Gautam ◽  
Saroj Adhikari Yadav ◽  
Rakesh Kumar Gupta
Keyword(s):  
Case Report ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Internal Hernia ◽  
Prior History ◽  
Emergency Laparotomy ◽  
Paraduodenal Hernia ◽  
Internal Hernias ◽  
Right Paraduodenal Hernia

Paraduodenal hernia, a rare internal hernia, is an uncommon cause of small bowel obstruction. We present a case report of a 45-year-old male presenting to the emergency department with complaints suggestive of small bowel obstruction. Abdominal plain X-ray was also suggestive of small bowel obstruction. Emergency laparotomy showed intraoperative findings of right sided paraduodenal hernia with dilated small bowel. Postoperative hospital stay was uneventful and the patient was doing well during 24 months of follow up with no active complaints. Paraduodenal hernia should be considered as part of the differential diagnosis of small bowel obstruction in patients who have repeated attacks and no prior history of abdominal surgery. Surgeons need to have an astute clinical acumen in diagnosing internal hernias to avoid repercussions and fatal events.

scholarly journals Internal hernia - a rare cause of small bowel obstruction: a case report

2016 ◽  
Vol 4 (1) ◽  
pp. 427 ◽  
Author(s):  
Samir U. Rambhia ◽  
Premjeet Madhukar
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Internal Hernia ◽  
Previous History ◽  
Exploratory Laparotomy ◽  
Internal Hernias ◽  
Post Surgery ◽  
History Of ◽  
Acute Small Bowel Obstruction

Internal hernia means a protrusion into pouches or openings in the peritoneum or mesentry in contrast to the hernias through defects in the retaining walls of the abdomen. Internal hernias are of many varieties with different classifications and can be congenital or acquired post-surgery. We present a case of a 55 year old female who presented with symptoms of acute small bowel obstruction with previous history of exploratory laparotomy 20 years back for reasons not known to her. Routine blood investigations, chest and abdomen skiagram and a CECT abdomen were performed (which gave no significant clue to diagnosis) and after a failed conservative trial patient was taken for exploration. Intra operatively a gangrenous loop of small bowel was found herniating through a band between the small bowel mesentry and the sigmoid mesocolon, forming a closed loop obstruction. Resection anastomosis of the gangrenous segment along with band transection was performed. The post-operative course was uneventful. Internal herniation as a cause of bowel obstruction should always be kept in mind as a differential.

scholarly journals Internal hernia with Roux loop gangrene in a post

2019 ◽  
Vol 6 (8) ◽  
pp. 2995
Author(s):  
Swaminathan Ganesan ◽  
Satish Devakumar
Keyword(s):  
Gastric Bypass ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Internal Hernia ◽  
Laparoscopic Exploration ◽  
Internal Hernias ◽  
Elective Repair ◽  
High Degree

High degree suspicion is mandatory in dealing with a post-operative patient presenting with a crampy postprandial abdominal pain, as potential for internal hernias remains fairly under diagnosed. Except in setting of small bowel obstruction or gangrene and radiological proven internal hernia, intervening a patient with herald symptoms is still debatable, though certain authors advocate that in lap. Roux-en Y gastric bypass patients with herald symptoms should promptly be offered elective laparoscopic exploration elective repair safely and expeditiously.

scholarly journals A rare case of intestinal obstruction caused by internal hernia through post hysterectomy peritoneal defect

2021 ◽  
Vol 8 (4) ◽  
pp. 1347
Author(s):  
Ravi Kumar Sabu Murugesan ◽  
Kannan Ross ◽  
Joyce Prabakar
Keyword(s):  
Small Bowel ◽  
Intestinal Obstruction ◽  
Internal Hernia ◽  
Rare Case ◽  
Emergency Laparotomy ◽  
Female Status ◽  
Internal Hernias ◽  
Bowel Movements ◽  
Operative Findings ◽  
Increasing Trends

Internal hernia is a rare cause of intestinal obstruction. Nowadays acquired internal hernias are in increasing trends due to increased surgical procedures thus iatrogenic causes surpassing congenital internal hernias. Internal hernias after hysterectomy due to peritoneal defect is extremely rare. Here we present a case of 67 years old female status post hysterectomy ten years back, also a known type 2 diabetic presented to the emergency department with features suggestive of intestinal obstruction. Patient was taken up for emergency laparotomy and intra operative findings revealed small bowel loops herniating in a cavity that is formed by bladder anteriorly, caecum and sigmoid colon laterally and rectum posteriorly. Bowel loops were released. The bowel was found to be viable and the defect was closed. Bowel movements resumed on the third post-operative day. This case is presented here as it is an extremely rare case of internal hernia causing small bowel obstruction.

scholarly journals Small bowel obstruction and strangulation secondary to an adhesive internal hernia post ESWL for right ureteral calculi: a case report and review of literature

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Elaine N. Gitonga ◽  
Haitao Shen
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Internal Hernia ◽  
Ureteral Calculi ◽  
Emergency Laparotomy ◽  
Extracorporeal Shock Wave ◽  
Relative Safety

Abstract Background Extracorporeal shock wave lithotripsy (ESWL) is a relatively safe and convenient mode of treatment for ureteral and renal stones, despite its relative safety; ESWL is not without its complications. We present a case of a patient we managed for small bowel obstruction and strangulation due to an adhesive internal hernia after ESWL was done because of right ureteral calculi. Case presentation We report a case of a 59-year-old patient who presented with severe abdominal pain a few hours after ESWL because of a right upper ureteric calculus. The abdominal pain increased in severity in time and became more generalized. The patient had one episode of gross hematochezia as she was being prepped for emergency laparotomy. Intra-op, she had a strangulated internal hernia because of an omental-mesenteric adhesion. Conclusion This case report hopes to highlight the potential of complications like acquired IH due to adhesions in patients with a history of ureteral calculi, and also the complications that may come about post-ESWL. Patients who present with signs of persistent abdominal pain post-ESWL should be vigilantly observed. If symptoms persist, increase in intensity or there is a general deterioration of the patients’ hemodynamic status, even in light of negative MDCT findings, prompt surgical intervention is crucial for definitive diagnosis as well as management.

Hernia interna estrangulada por plastrón en el tercio distal del apéndice cecal

2019 ◽  
Vol 62 (6) ◽  
pp. 24-27
Author(s):  
Leslie M. Leyva Sotelo ◽  
José E. Telich Tarriba ◽  
Daniel Ángeles Gaspar ◽  
Osvaldo I. Guevara Valmaña ◽  
André Víctor Baldín ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Early Diagnosis ◽  
Intestinal Obstruction ◽  
Acute Abdomen ◽  
Internal Hernia ◽  
Wide Spectrum ◽  
Internal Hernias ◽  
Mild Abdominal Pain ◽  
Made In

Internal hernias are an infrequent cause of intestinal obstruction with an incidence of 0.2-0.9%, therefore their early diagnosis represents a challenge. The most frequently herniated organ is the small bowel, which results in a wide spectrum of symptoms, varying from mild abdominal pain to acute abdomen. We present the case of an eight-year old patient with nonspecific digestive symptoms, a transoperative diagnosis was made in which an internal hernia was found strangulated by plastron in the distal third of the appendix. Appendectomy was performed and four days later the patient was discharged without complications.

scholarly journals THREE CASES OF BOWEL OBSTRUCTION BY BROAD LIGAMENT HERNIA

2021 ◽  
Vol 108 (Supplement_3) ◽  
Author(s):  
M Soto Dopazo ◽  
E Pérez Prudencio ◽  
A Arango Bravo ◽  
C Nuño Iglesias ◽  
C Mateos Palacios ◽  
...  
Keyword(s):  
Small Bowel ◽  
Bowel Obstruction ◽  
Broad Ligament ◽  
Intestinal Resection ◽  
Laparoscopic Approach ◽  
Exploratory Laparotomy ◽  
X Rays ◽  
Intestinal Necrosis ◽  
Urgent Surgery ◽  
Internal Hernias

Abstract INTRODUCTION Internal hernias caused by broad ligament defects are an infrequent cause of bowel obstruction. These defects may be congenital or acquired mainly by gynecological antecedents. Small bowel is the most common affected and the diagnosis is difficult due to nonspecific symptoms and absences of characteristic radiological signs. MATERIAL AND METHODS We report the cases of three women aged from 43 to 56 years old, who came to the emergency with abdominal pain, vomiting and bloating of hours duration. One patient has a history of laparoscopic appendectomy, the rest of them with no surgical history. In all of the cases, x-rays showed dilatation of small bowel loops and air-fluid levels and the abdominal TC revealed a generalized distention of bowel loops with transition point in the terminal ileum with no identifiable cause compatible with small bowel obstruction. RESULTS We decided to perform an urgent surgery with an exploratory laparotomy in one case and the rest by laparoscopic approach, finding an internal hernia occasioned by incarceration of small bowel through a broad ligament defect. In all cases, the hernia content was liberated without evidence of ischemia with no need for intestinal resection, and the defect was closed. All patients had a favourable postoperative course without complications. DISCUSSION Broad ligament defects are a rare cause of internal hernias. These are difficult to diagnose clinically as well as radiologically for an absence of characteristic signs. A high level of clinical suspicion allows early diagnosis and the treatment should be performed as soon as possible to reduce the chances of intestinal necrosis.

An interesting case of left paraduodenal hernia.

2021 ◽  
Vol 28 (05) ◽  
pp. 755-758
Author(s):  
Sahar Saeed ◽  
Abeera Butt ◽  
Syed Asghar Naqi ◽  
Muhammad Mohsin Ali
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Interesting Case ◽  
Paraduodenal Hernia ◽  
Absorbable Suture ◽  
Internal Hernias ◽  
Plain Abdominal Radiography ◽  
History Of ◽  
Operative Recovery

Paraduodenal fossa hernias (PDFHs) represent 53% of all congenital internal hernias and 0.2-0.9% of all small bowel obstructions. Most of these hernias are diagnosed incidentally on laparotomy, and carry up to 50% lifetime risk of development of small bowel obstruction. We present our experience in diagnosing and treating a case of a massive left paraduodenal fossa hernia in a 17 year male, containing over 30% of the small bowel (jejunum and ileum), presenting with a history of recurrent incomplete small bowel obstruction. Plain abdominal radiography showed distended loops of jejunum and few air fluid levels. After laparotomy and identification of hernia, small gut was reduced and examined, which was found to be structurally and functionally intact with normal vascularity. The defect was closed with continuous absorbable suture (Vicryl 2-0) sparing the inferior mesenteric vessels. Patient’s post-operative recovery remained uneventful and he was discharged on 4th post-operative day.

scholarly journals COLORECTAL CARCINOMA;

2013 ◽  
Vol 20 (03) ◽  
pp. 472-477
Author(s):  
MOHAMMAD ADNAN NAZEER ◽  
QAMAR SHAHZAD ◽  
HARUN MAJID DAR ◽  
Asma Samreen ◽  
Humaira Aalam
Keyword(s):  
Colorectal Carcinoma ◽  
Bowel Obstruction ◽  
Large Bowel ◽  
Standing Position ◽  
Large Bowel Obstruction ◽  
Sigmoid Volvulus ◽  
Colorectal Cancers ◽  
Fluid Interfaces ◽  
Biochemical Tests ◽  
Age Range

Introduction: Large bowel obstruction due to colorectal carcinoma occurs in up to 20% of the patients and usually2-4 accompanied by morbidity and mortality . Almost 25 % deaths occur post-operatively following surgery for colorectal cancers occur in1 those who initially present with obstruction . Usually elderly patients with associated co-morbidities presents with bowel obstruction.Objective: Find out the frequency of colorectal cancers in patients presenting with large bowel obstruction. Design: Prospective crosssectional study. Setting: Shaikh Zayed Hospital Lahore. Period: from 31st December 2010 to 31st December 2012. Materials &Methods: A total 20 patients were presented with large bowel obstruction with the age ranges between 40 to 70 years. All the 20 patientsunderwent routine haematological and biochemical tests. In these patients an abdominal x-ray in a supine or standing position was takenand dilated loops of bowel, air-fluid interfaces, or both was observed then Contrast radiography(Barium/gastrograffin) was done todefine the site and extent of the obstruction. An abdominal computed tomography scan was done to evaluate the extent of the disease.Colonoscopy was also carried out in the patients with colorectal cancers to find out the size and location of the tumor and biopsy taken bycolonoscope. Results: 12 patients out of 20 presented with large bowel obstruction were diagnosed to have a colorectal cancers and theage ranges from 60 to 70 years. The 8 patients were diagnosed to have a sigmoid colonic tumour and 4 patients were suffering from atumour of recto sigmoid junction. Whereas in rest of the 8 patients the large bowel obstruction was due to other benign causes likevolvulus and intussusception and age range was 50 – 60 years. 6 patients were suffering from sigmoid volvulus and remaining 2 hadcolo-colic intussusception. Conclusions: It is concluded that the major cause of the large bowel obstruction is the left sided colorectalcancers the tumours of recto sigmoid junction.

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