Laparoscopic treatment of small bowel strangulation caused by an intramesosigmoid hernia and review of literature

An internal hernia is defined as a protrusion of an abdominal viscera through the defects of the gastrointestinal mesentery or peritoneum-lined fossa. Sigmoid mesocolic hernias are an uncommon type of internal hernias, accounting for only 6% of all internal hernias. Furthermore, intramesosigmoid hernia is one of the three subtypes of the sigmoid mesocolic hernias. Internal hernias are potentially fatal conditions with diagnostic challenges. Patients presenting with acute obstruction, no surgical history and no external hernia should receive an urgent CT scan to facilitate early surgery and to minimise the risk of strangulation and bowel resection. Here, we report a case of strangulated small bowel obstruction secondary to an intramesosigmoid hernia with a successful laparoscopic repair. We also present a literature review of all reported cases so far and give an up-to-date perspective on intramesosigmoid hernia.

Small bowel obstruction secondary to intramesosigmoid hernia

Intramesosigmoid hernias are a rare cause of small bowel obstruction. Here, we present such a case with learning points derived from diagnostic dilemma, shared decision making in consent and the management of a rare cause of a common surgical emergency.