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.

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 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 Rare case of paracaecal hernia with intussusception presenting as small bowel obstruction: case report

2020 ◽  
Vol 7 (5) ◽  
pp. 1662
Author(s):  
M. S. Kalyan Kumar ◽  
Shyamsundar R. ◽  
Sabari Girieasan M. ◽  
R. Kannan ◽  
S. Nedunchezhiyan
Keyword(s):  
Intestinal Obstruction ◽  
Internal Hernia ◽  
Exploratory Laparotomy ◽  
Acute Intestinal Obstruction ◽  
Emergency Laparotomy ◽  
High Morbidity ◽  
Rare Presentation ◽  
Ileal Loop ◽  
Rare Type ◽  
Internal Hernias

Primary internal hernias are very rare in adults. They are an unusual cause of small intestinal obstruction and lead to high morbidity and mortality if left untreated. Clinical presentation of internal hernia is highly nonspecific. Imaging has limited role in diagnosing the cause of acute intestinal obstruction. Internal hernias are usually detected at laparotomy. We report a case of a 61-year-old male who presented with acute intestinal obstruction which was attributed later to a very rare type of internal hernia on exploratory laparotomy. A loop of ileum was found to enter the retroperitoneum through a hernia gate which was located lateral to the caecum and ileo ileal intussusception was noted proximal to the herniated loop. The segment of intestine was resected and anastamosed then hernial defect was closed. Paracaecal hernias are the rare type of hernias in internal hernia. In our case, intussusception was noted proximal to the herniated ileal loop which is a very rare presentation. Intussusception was reported previously with paraduodenal type. One should always keep in mind while conducting emergency laparotomy, internal hernias can be a cause for intestinal obstruction.

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 Closed loop obstruction and adhesive intestinal obstruction in perineal hernia

2020 ◽  
Vol 13 (12) ◽  
pp. e238112
Author(s):  
Ramprasad Rajebhosale ◽  
Mohammad Miah ◽  
Fraser Currie ◽  
Pradeep Thomas
Keyword(s):  
Small Bowel ◽  
Intestinal Obstruction ◽  
Rare Case ◽  
Transition Point ◽  
Closed Loop ◽  
Abdominoperineal Excision ◽  
Perineal Hernia ◽  
Bowel Gangrene ◽  
Adhesive Intestinal Obstruction

Perineal hernia with bowel gangrene is uncommon but known complication of laparoscopic extralevator abdominoperineal excision (ELAPE). We present a rare case of closed loop small bowel obstruction with bowel gangrene secondary to an incarcerated perineal hernia that developed 7 years after an ELAPE. Intraoperatively, we found a definitive transition point due to adhesions in pelvis and a closed loop obstruction of the distal small bowel at different site with gangrenous intestine. She was managed successfully surgically with adhesiolysis and fixation of defect with biological mesh. Prevalence of perineal hernias will rise in future because of the increasing cases of ELAPE, in which no repair of pelvic floor is performed. The need of follow-up of these operations and more reporting of such cases are important in increasing awareness of these complications. Patients should be made aware of such complications and should seek urgent medical care.

A RARE CASE OF HETEROTOPIC PANCREATIC TISSUE CAUSING SMALL BOWEL OBSTRUCTION

2021 ◽  
pp. 4-5
Author(s):  
B. Santhi ◽  
M. Annapoorani ◽  
Sharada bhavana
Keyword(s):  
Intestinal Obstruction ◽  
Rare Case ◽  
Histopathological Examination ◽  
Pancreatic Tissue ◽  
Acute Intestinal Obstruction ◽  
Emergency Laparotomy ◽  
Review Of Literature ◽  
Heterotopic Pancreatic Tissue ◽  
Small Growth ◽  
Upper Gastrointestinal

A Rare case of heterotopic pancreatic tissue of ileum causing acute intestinal obstruction has been described with a brief review of literature. A 42 yr old male patient presented to the emergency department with features of acute intestinal obstruction. After evaluation patient was taken up for emergency laparotomy which revealed a band to be arising from ileum. Furthermore, there was a small growth in the ileal wall at the site of origin of the band. Hence resection of the growth was done and followed by ileoileal anastomosis. Later on, histopathological examination of the growth revealed it to be heterotopic pancreatic tissue. Heterotopic pancreatic tissue is often an incidental nding encountered in upper gastrointestinal tract during endoscopy and surgeries. But Symptomatic ectopic pancreas of ileum is relatively rare and they very rarely present with acute symptoms as in this case

scholarly journals Strangulated internal hernia through the lesser omentum with intestinal necrosis: a case report

2002 ◽  
Vol 120 (3) ◽  
pp. 84-86 ◽  
Author(s):  
Gustavo Gibin Duarte ◽  
Belchor Fontes ◽  
Renato Sérgio Poggetti ◽  
Marcos Roberto Loreto ◽  
Paulo Motta ◽  
...  
Keyword(s):  
Case Report ◽  
Intestinal Obstruction ◽  
Internal Hernia ◽  
Clinical Manifestations ◽  
Acute Intestinal Obstruction ◽  
Main Task ◽  
Intestinal Necrosis ◽  
Lesser Omentum ◽  
Lesser Sac ◽  
Internal Hernias

CONTEXT: Internal hernias account for only 0.2 to 0.9% of the cases of intestinal obstruction. They do not have specific clinical manifestations, and are usually diagnosed during laparotomy for acute intestinal obstruction. Internal hernias through the lesser omentum are extremely rare. CASE REPORT: We report here the case of a 36-year-old patient who underwent exploratory laparotomy for acute intestinal obstruction. An internal hernia through the lesser omentum was found, with a strangulated ileal segment passing through the perforation into an abscess within the lesser sac. The surgical procedures included ileal resection, primary anastomosis, abscess removal, and placement of a drain in the lesser sac. The patient was reoperated 6 days later for abdominal sepsis; a lesser sac abscess was removed and the abdominal incision was left open. The patient stayed in the Intensive Care Unit for 15 days, and eventually left the hospital on the 28th post-admission day, with complete recovery thereafter. CONCLUSION: The early diagnosis of acute intestinal obstruction and immediate indication for laparotomy is the main task of the surgeon when faced with a case of acute abdomen with a hypothesis of internal hernia, so as to minimize severe postoperative complications, as illustrated by the present case.

Internal Hernia: Postoperative Complication of Roux-en-Y Gastric Bypass Surgery

2006 ◽  
Vol 72 (7) ◽  
pp. 581-585 ◽  
Author(s):  
Aaron Eckhauser ◽  
Alfonso Torquati ◽  
Yassar Youssef ◽  
Joan L. Kaiser ◽  
William O. Richards
Keyword(s):  
Gastric Bypass ◽  
Length Of Stay ◽  
Intestinal Obstruction ◽  
Internal Hernia ◽  
The United States ◽  
Morbidity And Mortality ◽  
Transverse Mesocolon ◽  
Surgical Morbidity ◽  
Internal Hernias ◽  
Clinical Awareness

Obesity surgery is becoming one of the most common general surgery procedures done in the United States. Internal hernias are a known and increasingly more common occurrence after laparoscopic roux-en-Y gastric bypass (LRYGB). Increased clinical awareness of this complication will lead to decreased surgical morbidity and mortality. We retrospectively reviewed our database of 529 patients who had undergone LRYGB from 2000 to 2005 and identified those presenting with intestinal obstruction from an internal hernia. The type of internal hernia (jejunojejunostomy, transverse mesocolon, roux limb mesentery [Peterson's hernia]), length of time from presentation to operative intervention, and length of stay were obtained for all patients. Of 529 laparoscopic retrocolic retrogastric LRYGBs, 13 internal hernias (2.5%) were identified in 13 different patients. Eight of the hernias were at the mesenteric defect created by the jejunojejunostomy (62%), 3 originated from the transverse mesocolon defect (23%), and 2 were a Peterson's hernia (15%). The median time from initial operation to repair was 150 days. The average time from presentation to operative repair was 29.2 hours (range, 5–67.5 hours). The median length of stay was 3 days (range, 1.5–45 days). Eleven hernias were repaired laparoscopically (85%). There were no mortalities associated with obstruction from the internal hernia. Intestinal obstruction from an internal hernia after LRYGB is becoming increasingly more common. General awareness of this condition and high clinical suspicion allow for prompt surgical intervention with decreased morbidity and mortality.

scholarly journals Small-bowel Intestinal Obstruction Caused by an Unusual Internal Hernia

2005 ◽  
Vol 28 (1) ◽  
pp. 62-64 ◽  
Author(s):  
Jimmy C.M. Li ◽  
David W. Chu ◽  
Danny W.H. Lee ◽  
Angus C.W. Chan
Keyword(s):  
Small Bowel ◽  
Intestinal Obstruction ◽  
Internal Hernia
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