Incarcerated transmesosigmoid hernia presenting in a 60-year-old man: a case report

Danielle Collins,Dara Kavanagh,Enda Mcdermott,Steve Richards,Eddie Myers

doi:10.1186/1752-1947-2-161

Danielle Collins, Dara Kavanagh + Show 3 more

Open Access

https://doi.org/10.1186/1752-1947-2-161

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Abstract

IntroductionInternal hernias are a rare cause of small bowel obstruction and are estimated to account for 1% to 5% of cases. Herniation through a defect in the sigmoid mesocolon constitutes 6% of all internal hernias.Case presentationIn this case report we describe a rare case of a fit and healthy 60-year-old man, with no previous history of abdominal surgery, who presented with signs and symptoms of small bowel obstruction as a result of an incarcerated transmesosigmoid hernia. The hernia was reduced and the incarcerated loop of small bowel was found to be viable. The patient made a good recovery and was discharged home on the fourth post-operative day.ConclusionInternal hernias can cause considerable morbidity and mortality, so prompt diagnosis is paramount. Transmesosigmoid hernias are most common in the paediatric population; however, our patient was 60 years old. This report highlights the importance of considering an internal hernia as a cause of small bowel obstruction in individuals of all age groups and especially in those without a previous history of abdominal surgery.

Highlights

Internal hernias are a rare cause of small bowel obstruction and are estimated to account for 1% to 5% of cases
Transmesosigmoid hernias are most common in the paediatric population; our patient was 60 years old
Internal hernias are an infrequent cause of small bowel obstruction and are estimated to account for 1% to 6% of all cases

Summary

Conclusion

This case highlights a rare cause of intestinal obstruction in a patient with no previous abdominal surgery. Congenital internal hernias are more common in the paediatric population [6]. The current case was a 60year-old man. The developmental evolution of the mesenteric defect has not been fully elucidated. There is a high incidence of strangulation and small bowel ischaemia with subsequent morbidity and mortality. With the widespread use of laparoscopic abdominal surgery, internal hernias may become an increasing surgical problem. In cases of small bowel obstruction without previous abdominal surgery, a congenital internal hernia should be considered. Prompt diagnosis and intervention enabling active management are paramount

Introduction

Discussion

Findings

Ghahremani GG