Internal Supravesical Hernia Research Articles

Internal Supravesical Hernia Revealed by Small Bowel Obstruction

Small bowel obstruction secondary to ingested fish bone is an exceedingly rare occurrence, particularly among the elderly, accounting for less than 1% of cases necessitating surgical intervention. This article reports a case of an 84-year-old male who presented with acute abdominal pain and bilious vomiting for seven days after accidentally swallowing a fish bone. Computed Tomography (CT) of the abdomen and pelvis indicated sub-acute bowel obstruction, revealing a linear foreign body in the jejunum with a focal collection. An emergency exploratory laparotomy uncovered a pocket of pus containing the fish bone in the mesentery of the jejunum, with evidence of perforation at approximately 150 cm distal to the duodenojejunal flexure.

Internal Supravesical Hernia Revealed by Small Bowel Obstruction

The supravesical hernia is a rare cause of internal hernia, characterized by the protrusion of the intestine through an abnormal intra-abdominal opening located in the supravesical compartment. This anomaly is infrequently reported in the literature, and its incidence remains uncertain [1]. Supravesical hernias predominantly affect men over the age of 50 [2]. From a pathophysiological perspective, supravesical hernias develop from the supravesical fossae. They form medial to the umbilical arteries and often expand into the Retzius space, though they can also engage laterally, resulting in laterovesical hernias. These hernias are almost always acquired and can sometimes be associated with inguinal hernias. Clinically, they present as acute bowel obstruction. An abdominal CT scan can confirm the diagnosis of obstruction but rarely provides an etiological diagnosis [3]. In such cases, a median laparotomy is necessary, and intraoperative diagnosis is typically straightforward. Treatment involves sectioning the hernial neck and reducing the hernia, followed by simple closure of the opening using separate sutures with absorbable thread [4]. We report a case of a 56-year-old patient with no notable medical history was admitted to the emergency department with an internal supravesical hernia revealed by obstructive syndrome.

Neodymium magnets migrated into an internal supravesical hernia: a rare case of foreign body ingestion in children

BackgroundForeign body (FB) ingestion is a common event in children. The management of the ingested FB depends on the location, type, number, size of the FBs, patient age, and symptoms. Although most FBs pass spontaneously through the gastrointestinal tract without causing serious injuries, the ingestion of multiple high-powered magnetic pieces, especially neodymium magnets (NMs) increases the risks of morbidity and mortality. Supravesical hernia (SH) is rarely occurs in children, and few studies have reported SH in pediatric patients. We report an extremely rare case of ingested NMs that migrated into an internal SH in a pediatric patient.Case presentationA 3-year-old boy who had accidentally swallowed two NMs 3 days ago presented with vomiting and lower abdominal pain. X-ray imaging and computed tomography (CT) suspected the presence of a 1.0-cm radiopaque FB located in the terminal ileum dorsal side of the bladder. Although his abdominal pain was gradually getting better after oral feeding, repeat abdominal X-ray imaging showed that the FB was in a stagnant in position. Therefore, surgical intervention was planned to remove the FB 1 week after his admission. Under general anesthesia, laparoscopic and fluoroscopic examinations were performed and the cecum was found adhered to the retroperitoneum between the right medial umbilical fold and the right wall of the urinary bladder. The FB was presumed to be located at the tip of the incarcerated cecum in the retroperitoneal space. Peritoneum incision was started near the medial inguinal fossa, and the Retzius space was opened in a manner similar to the transabdominal pre-peritoneal approach for inguinal hernia repair. Consequently, the patient was diagnosed with internal SH with FB migration. The incarcerated cecum was pulled out, which revealed intestinal wall perforation. The FB remained in the retroperitoneal space in the pelvic cavity. The FB was easily removed using intestinal forceps and identified as combined two NMs. The postoperative course was good, and the patient was discharged on postoperative day 5.ConclusionsWe experienced an extremely rare case of a pediatric patient who swallowed multiple NMs that migrated into an internal SH, and the laparoscopic minimally invasive removal was successful.

Internal Supravesical Hernia: A Rare Cause of Acute Small Bowel Obstruction

Supravesicular hernia is unusual and little reported in the literature. The diagnosis is not simple. Unrecognized or untreated, supravesicular hernia can lead to occlusive complication, which implies urgent surgical treatment, with the risk of having to resort to a stoma. We report a rare case of an internal supravesical hernia revealed by an acute small bowel obstruction. An emergency operation was performed. The bowel was edematous but still viable. The supravesical hernia’s ring was repaired, and the patient made a good recovery.

Internal Supra-Vesical hernia: A very rare cause of small bowel obstruction and review of literature

Internal Supravesical hernia is an unusual type of hernia. Small bowel obstruction due to the Supravesical hernia is very rarely seen. Clinical diagnosis of this hernia is almost never suspected before surgery; hence familiarity with this condition as well as the anatomy of the Supravesical fossa may allow preoperative diagnosis by CT in a few instances.

Supravesical hernias: a systematic review of the literature.

A supravesical hernia (SH) is a rare abdominal wall hernia that is defined by the protrusion of abdominal viscera through the supravesical fossa. The objective of this study was to review current literature on SHs and elucidate their clinical manifestations and preferred therapeutic approach. PubMed, Embase and Cochrane bibliographical databases were searched (last search: 30 March 2020) for articles reporting on SHs. Thirty-four studies met our inclusion criteria and involved collectively 38 patients (94.7% males) with an age of 59.57 ± 14.84 (mean ± standard deviation) years. Abdominal pain (81.6%) and nausea and vomit (71.1%) were the most frequently encountered symptoms. The majority of patients (78.1%) had signs of bowel obstruction. Twenty-nine patients (76.3%) suffered from an internal SH, while nine (23.7%) had an external one. An open hernia repair was conducted at 29 patients (76.3%), while eight (21.1%) had a laparoscopic approach and in one case (2.6%) the laparoscopic operation was converted to an open one. A mesh was applied at 14.3% of included cases. Eight patients (21.1%) underwent a bowel resection and hernia sac was resected at six (15.8%) cases. Four patients (11.8%) experienced postoperative complications and one patient (2.9%) died on first postoperative day. SH is an extremely rare type of hernia occurring through the supravesical fossa between the remnants of urachus and foetal umbilical arteries. All clinicians should be aware of this entity and further studies are necessary in order to clarify their aetiology, true incidence and optimal therapeutic approach.

Hernia supravesical como causa de obstrucción intestinal: reporte de un caso

Las hernias abdominales internas son una causa poco frecuente de obstrucción intestinal, que se presentan por el deslizamiento de los órganos intraabdominales, en especial el intestino delgado, a través de defectos congénitos o adquiridos en el mesenterio o en los espacios intraperitoneales. La hernia supravesical interna es una de las presentaciones menos frecuentes de esta entidad y su diagnóstico es intraoperatorio en la mayoría de los casos.
 Se presenta el caso de un paciente de sexo masculino que consultó con manifestaciones de obstrucción intestinal, y fue sometido a cirugía de urgencias, con el hallazgo de una hernia supravesical interna.

Laparoscopic treatment of obstructed internal supravesical hernia: A cases series and rewiev of the literature.

Introductioninternal supravesical hernia (ISH) is an exceptional subtype of internal hernia often presenting with small bowel obstruction (SBO). Its rarity makes preoperative suspicion and diagnosis very difficult in an emergency setting.Methodswe retrospectively analyzed the database of patients admitted in a single center emergency unit for small bowel occlusion (SBO) in virgin abdomen and treated by surgery from August 2013 to October 2018. The patients with intraoperative diagnosis of ISH were included in this study.Resultsfrom 29 patients with virgin abdomen submitted to surgery for SBO, two cases of ISH were recorded. In both cases preoperative diagnosis was made by CT scan and urgent treatment was successfully performed by laparoscopy, reducing the entrapped small bowel and closing the hernia's ring by continuous suture. No intestinal resection was needed.Discussionurgent laparotomic repair of obstructive ISH is the standard treatment although laparoscopic approach has also been described in a small number of cases. We reported our experience on two cases in which totally laparoscopic treatment was successfully performed in patients with stable hemodynamic parameters thanks to early diagnosis and limited intestinal distension. By an extensive analysis of the international literature, clinical, diagnostic and therapeutic aspects of this form of internal hernia were discussed.ConclusionCT scan facilitates early ISH preoperative diagnosis, reducing the risk of small bowel resection and increasing the chances of minimally invasive laparoscopic treatment.

Internal supravesical hernia

Internal supravesical hernia is a rare condition with unclear presentation features. If an obstructed hernia is suspected, computerized tomography (CT) can aid diagnosis; some cases are diagnosed at exploratory laparotomy. We report the case of a 72-year-old man who presented with an irreducible left inguinal hernia and an associated supravesical hernia. The diagnosis was suspected during CT and exploratory laparotomy was performed. With early diagnosis and management, supravesical hernias can have an excellent prognosis.

腹腔鏡手術で診断治療した内膀胱上窩ヘルニアの1例

腹腔鏡手術で診断治療した内膀胱上窩ヘルニアの1例

Obstrucción intestinal causada por hernia supravesical interna

The patient is a 74-year-old male who came to our consultation due to bowel obstruction. He presented a distended abdomen with pain in the hypogastrium and signs of peritoneal irritation. Physical examination ruled out the existence of inguinal hernia. CT revealed distension of the small bowel, and the appearance of the terminal ileum in the hypogastrium was suggestive of band obstruction (Fig. 1). Laparotomy was performed. An internal supravesical hernia was observed that contained the ileal loop with signs of ischemia, which improved after its release (Fig. 2). The defect was closed with continuous polydioxanone suture. Internal supravesical hernias should be considered in cases of intestinal obstruction without previous surgery or signs of complicated external hernias. c i r e s p . 2 0 1 5 ; 9 3 ( 1 ) : e 1

Internal supravesical hernia accompanied with anomalous fold formations: a cadaveric case report

During the abdominal dissection of a 67-year-old male cadaver, an unusual peritoneal fold was encountered on the inner surface of the anterior abdominal wall. The peritoneal fold had two parts: the anterior part was located at the midsagittal plane including dispersed urachus remnants, the other part was located at the coronal plane with a triangular shape at the posterior edge of the sagittal part. Remnants of the umbilical arteries were ascending in the lateral margins of the coronal part. Accordingly, two peritoneal sacs were formed on both sides of this abnormal fold. Part of the small bowel herniated into the left peritoneal sac situated on the left side of the bladder. Although the aperture of the hernia sac was at the lateral side of the remnant of the umbilical artery which is concordant with the normal position of the medial inguinal fossa, the bottom of the sac was found to be located at the supravesical region. Therefore, this case was interpreted as an internal supravesical hernia with an unusual course. Although these rarely seen internal supravesical hernias in the literature were reported to be observed either preoperatively or postoperatively, to our knowledge our case is the first to be revealed in a cadaver which in detail enabled us to examine the features of this unique peritoneal variation and accompanying anatomic structures that caused hernia formation.

内膀胱上窩ヘルニアの1例

症例は腹部手術歴のない60歳男性．下腹部痛，腹部膨満を主訴に来院した．腹部レントゲン検査，CT検査では小腸イレウスを認め，数年前から時々右鼠径部の膨隆を自覚していたことから，鼠径ヘルニア嵌頓を疑ったが，認めなかった．入院し保存的加療を行うもイレウスは改善せず，内ヘルニアの診断で手術を施行した．開腹所見では回腸が右膀胱上窩に嵌頓しており内膀胱上窩ヘルニア嵌頓によるイレウスと診断した．腸管壊死は認めず，腸切除は要さなかった．内膀胱上窩ヘルニアはまれな疾患であり，本邦報告例は自験例が21例目である．さらに，自験例では鼠径部に膨隆を形成する外膀胱上窩ヘルニアの所見も有していたと考えられた．内膀胱上窩ヘルニアはまれな疾患であるため，術前診断は非常に困難であるが，特徴的なCT像を呈するなど，認識を深めれば術前診断は可能である．原因不明のイレウスの診療の際には念頭に置くべき疾患の一つと考えられる．

腹腔鏡下に修復した内膀胱上窩ヘルニアの1例

症例は52歳，男性．腹痛と腹部膨満感が出現し近医を受診．腹部レントゲンで小腸ニボーを認め，イレウスの診断で入院加療を行ったが改善せず，造影CTを施行したところ小腸腫瘍が疑われた．イレウス管挿入で腸閉塞症状は改善したが，イレウス管造影で骨盤内に小腸の狭窄像を認め，小腸腫瘍によるイレウスの診断で手術目的で当院紹介となった．腹腔鏡下に手術施行したところ，腫瘍性病変は認めず，回腸末端から2m程度口側で小腸の一部が膀胱上窩に嵌頓している所見を認めた．手術は嵌頓した小腸を剥離しヘルニア門の縫合閉鎖を行った．術中所見から，内膀胱上窩ヘルニア嵌頓によるイレウスと診断した．内膀胱上窩ヘルニアは非常にまれな疾患であり，術前診断は非常に困難である．本症例も術前に正診には至らなかった．原因不明のイレウスで発症した症例では，本症の存在も念頭に置くべきであると考えられた．

Internal supravesical hernia - a rare cause of intestinal obstruction: report of two cases

Internal supravesical hernia - a rare cause of intestinal obstruction: report of two cases

Internal supravesical hernia: An unusual cause of small bowel obstruction

Internal hernia of the supravesical fossa is an unusual cause of small bowel obstruction. We report the case of a patient without previous abdominal surgery with an acute abdominal obstruction in which laparoscopic exploration revealed a strangulated internal supravesical hernia. To help clinicians with their pre-operative diagnosis and to better understand the clinical management of this unusual internal hernia, a description of the anatomy of the supravesical fossa is included in this case report.

Multidetector-Row CT Findings of an Internal Supravesical Hernia: A Case Report

A supravesical hernia occurs in the supravesical fossa and is either classified as an external or internal supravesical hernia. Most patients with internal supravesical hernias present with small bowel obstruction. Internal supravesical hernias are less common than external supravesical hernia. To date, there are few reports describing the radiological findings of supravesical hernias. To our knowledge, this is the first reported multidetector row CT (MDCT) depiction of this type of hernia. We report here on the MDCT findings of a patient with an internal supravesical hernia presenting with small bowel obstruction.

Internal supravesical hernia as a rare cauase of intestinal obstruction: a case report

IntroductionSupravesical hernias develop at the supravesical fossa between the remnants of the urachus and the left or right umbilical artery. They are often the cause of intestinal obstruction. We describe the anatomical variant of the supravesical hernia in this case and discuss the pre-operative findings revealed by computed tomography. We discuss diagnostic and therapeutic procedures, and review other anatomical variants.Case presentationA 60-year-old Senegalese man was admitted with a two-day history of small bowel obstruction. A physical examination showed abdominal distension. An abdominal X-ray revealed dilated small bowel loops. A computed tomography scan showed an image at the left iliac fossa that suggested an intussusception. A median laparotomy showed a left lateral internal supravesical hernia. The hernia was reduced and the defect was closed. The patient recovered uneventfully.ConclusionsSupravesical hernia is a possible cause of intestinal obstruction and diagnosis is very often made intraoperatively. Morphological examinations, such as computed tomography scanning, can lead to a preoperative diagnosis. Laparoscopy may be useful for diagnosis and therapy.

Internal supravesical hernia

Internal supravesical hernia is a rare cause of intestinal obstruction and a clinical diagnostic problem. We demonstrate its computed tomography (CT) appearance and believe familiarity with the anatomy of the supravesical fossa may allow the preoperative diagnosis.

Supravesical hernia – A rare cause of intestinal obstruction

Supravesical hernia is an unusual type of hernia. It is of two types: internal and external [Skandalakis JE, Gray SW, Burns WB, Sangmalee U, Sorg JL. Internal and external supravesical hernia. Am Surg 1976 Feb; 42(2):142–6]. We are reporting a case of internal supravesical hernia, in a 62-year-old gentleman to call attention to the entity, as a rare cause of intestinal obstruction.