Treves' field transmesenteric hernia causing acute small bowel obstruction in a 9-year-old girl

Abstract

Abstract Intestinal obstruction usually occurs as a result of postoperative adhesion; only rarely have there been reports of Treves' field transmesenteric hernia as a cause of intestinal obstruction in patients without preceding abdominal surgery. A 9-year-old girl presented with recurrent episodes of abdominal pain and vomiting. A plain radiograph showed mechanical bowel obstruction, and abdominal CT failed to show a definitive etiology of the obstruction. Laparotomy revealed Treves' field transmesenteric herniation without bowel strangulation. Reduction and closure of the defect cured the patient. Recurrent obstructive symptoms and spontaneous resolution can be a presentation of Treves' field transmesenteric hernia in patients without predisposing factors of intraabdominal adhesion. Diagnosis could be aided by radiological examination, but prompt initiation of surgical exploration on the basis of clinical presentation is mandatory in suspected cases to avoid significant bowel injury.