Strangulation Of Small Intestine Research Articles

Successful intestinal blood flow evaluation using indocyanine green fluorescent imaging in a case of small intestine strangulation: a case report

Abstract Introduction The assessment of intestinal blood flow using indocyanine green (ICG) fluorescence imaging is useful in ischemic bowel disease because it renders blood flow visible. Strangulated small intestine is a common postoperative complication requiring massive bowel resection, which can cause short bowel obstruction (SBO), a malabsorptive condition. Here, we report a successful case of preserving an ischemic intestinal segment while avoiding SBO based on the gap between the macroscopic findings and the ICG fluorescence imaging assessment. Case presentation A 46-year-old Japanese female patient who underwent an abdominal total hysterectomy and bilateral salpingo-oophorectomy with para-aortic lymphadenectomy due to small round cells of the left ovary was diagnosed with strangulated small intestine 1 month postoperatively. Macroscopic examination during the laparotomy revealed a strangulated small intestine with severe edema and dark red discoloration. However, this part of the bowel was preserved during surgery because the two-time administration of ICG solution revealed adequate perfusion. Conclusion This report reveals the effectiveness of ICG fluorescence imaging in intra-operative intestinal perfusion and its role in avoiding unnecessary massive resections. Combining these modalities may be effective for intra-operative bowel assessment; however, more accurate criteria and algorithms for evaluating blood flow and bowel perfusion should be established.

Small intestinal strangulation in 60 cattle – clinical, laboratory and ultrasonographic findings, treatment and outcome

BackgroundIntestinal strangulation is constriction of the intestine by a band of tissue, ligament or blood vessel causing partial or complete intestinal obstruction. This retrospective study describes the clinical, laboratory and ultrasonographic findings, treatment and outcome of 60 cows with intestinal strangulation.ResultsThe general condition was abnormal in all cows (60/60), 23.3% (14/60) had nonspecific signs of pain, 40.0% (24/60) had signs of colic and 48.3% (29/60) had signs of somatic (parietal) pain. The most common digestive tract abnormalities were, in decreasing frequency, reduced or absent intestinal motility (100%, 60/60), reduced or absent faecal output (98.3%, 59/60), reduced or absent rumen motility (93.4%, 56/60), dilated small intestines on transrectal palpation (63.3%, 38/60), positive ballottement and swinging auscultation (BSA) and/or percussion and simultaneous auscultation (PSA) on the right side of the abdomen (58.3%, 35/60) and at least one positive foreign body test, most commonly the back grip, in 33.9% (20/59) of the cows. Other common findings were reduced skin surface temperature (67.8%, 40/59), reduced skin turgor (51.7%, 31/60), prolonged capillary refill time (49.2%, 29/59), enophthalmus (48.3%, 29/60) and moderate to severe scleral injection (46.6%, 27/58). The most common laboratory findings were hypokalaemia (58.3%, 35/60), haemoconcentration (57.6%, 34/59), base excess (51.1%, 24/47), hyperproteinaemia (45.8%, 27/59), hyperbilirubinaemia (43.3%, 26/60), acidosis (42.6%, 20/47) and azotaemia (38.3%, 23/60). The principal ultrasonographic findings were subjectively reduced or absent small intestinal motility and dilated small intestines, but the strangulation could not be visualised by ultrasonography. With one exception, all cows underwent a right flank laparotomy to resolve the strangulation by transection or resection of the impinging tissue. Forty-nine (81.7%) cows were discharged and 11 (18.3%) were euthanized before, during or after surgery.ConclusionsWithout laparotomy, intestinal strangulation could be clinically (transrectally) diagnosed in only 10% of the cows. A laparotomy is therefore essential for the correct diagnosis. The prognosis is good with prompt surgical treatment.

Surgical Repair of Diaphragmatic Hernia-Related Small Intestinal Strangulation in a Neonatal Foal

Surgical Repair of Diaphragmatic Hernia-Related Small Intestinal Strangulation in a Neonatal Foal

Congenital trans-mesenteric hernia as a cause of small intestine strangulation in a dog

Congenital trans-mesenteric hernia as a cause of small intestine strangulation in a dog

Changes in equine intestinal stem/progenitor cell number at resection margins in cases of small intestinal strangulation.

Intestinal epithelial stem cells (ISC) are responsible for epithelial regeneration and are critical to the intestine's ability to regain barrier function following injury. Evaluating ISC biomarker expression in cases of small intestinal strangulation (SIS) may provide insight into clinical progression. Intestinal resection margins from cases of SIS were evaluated to determine if (1) evidence of injury could be identified using histomorphometry, (2) ISC biomarker expression was decreased in the proximal resection margin compared to control and distal resection margin, and (3) the ISC biomarker expression was associated with the number of preoperative risk factors negatively related to outcome, post-operative complications, or case outcome. Retrospective cohort study. Intestinal samples were obtained intraoperatively from resection margins of adult horses with SIS and horses euthanised for reasons unrelated to colic. Preoperative risk factors negatively related to outcome, post-operative complications, and case outcome were obtained from medical records. Horses were grouped as euthanised intraoperatively, postoperatively, or survived to discharge. Histomorphometry and immunofluorescence were performed to evaluate tissue architecture and ISC and progenitor cell number. Groups were compared using one-way ANOVA. Associations between biomarker expression and the number of preoperative risk factors and post-operative complications negatively related to outcome were determined using linear regression modelling. Thirty-six cases of SIS were evaluated. Ki67+ cell counts were decreased in the proximal (mean=15.45 cells; 95% CI= 10.27-20.63; SD=4.17; p= 0.02) and distal resection margins (mean=15.05; 95% CI=8.46-21.64; SD=4.141; p= 0.03) in horses euthanised postoperatively compared to control (mean=23.62 cells; 95% CI=19.42-27.83; SD=5.883). In the distal resection margin, an increase in SOX9+ Ki67+ cells were associated with a decrease in the total number of preoperative risk factors negatively related to outcome (95% CI = 0.236-1.123; p= 0.008, SE=0.1393). Small population size. Proliferating cell and ISC numbers may be associated with case outcome.

Entrapment of a jejunocecostomy anastomosis in the epiploic foramen in a horse

A mare aged 9 years underwent surgical correction of a small intestinal volvulus using a side-to-side, hand-sewn jejunocecal anastomosis. Nine months after the jejunocecostomy, the horse developed colic signs and ultrasonographic examination revealed gas in the large colon in the upper right flank region and several enlarged loops of the small intestine in the lower right flank area. The differential diagnosis was right dorsal displacement of the large colon or small intestinal strangulation. The exploratory celiotomy found epiploic foramen entrapment (EFE) of the jejunocecostomy anastomosis, including parts of the distal jejunum and cecum. Manual reduction of herniation of the bowel in the epiploic foramen (EF) was impossible and the horse was euthanized. The postmortem gross finding revealed the enlarged edematous at the distal end of the jejunum and the initial body portion of the cecum had passed into the EF in the right-to-left (antegrade) direction. To the authors’knowledge, this is the first report of the antegrade epiploic foramen entrapment of a jejunocecostomy bowel part and this may be one of the complications encountered during the long-term survival period of a surgical jejunocecostomy in horses.

Use of barbed suture for thoracoscopic repair of diaphragmatic hernias: Three cases

SummaryThree horses were diagnosed with a dorsally located diaphragmatic hernia/tear associated with either a penetrating injury in the first case or with signs of small intestine strangulation in the remaining two cases. After diagnosis during exploratory thoracoscopy (Case 1) or emergency laparotomy (Cases 2 and 3), closure of the dorsal defect in the diaphragm was performed through a thoracoscopic approach in all cases. Defects were closed with barbed suture with either a direct suturing technique or an automated suturing device. All horses recovered uneventfully and were alive at follow‐up (2 to 3 years after surgery). No significant complications or recurrence were reported.

Effects of age, disease and anastomosis on short- and long-term survival after surgical correction of small intestinal strangulating diseases in 89 horses.

Although survival rates have been reported after small intestinal surgery for strangulating diseases in horses, none have followed survival for periods relevant to the long lifespan of horses and none have described effect of age, disease and surgical treatments over such long survival periods. To examine effects of age, disease and type of surgery on long-term survival in horses after surgical treatment of small intestinal strangulating diseases over periods relevant to the expected lifespan of a horse. Retrospective clinical study. Post-operative data were gathered from medical records and owner contact for 89 horses with small intestinal strangulation. Survival times from surgery to the date of death or the date of last follow-up were analysed by Kaplan-Meier statistics. Variables of interest were age, type of strangulating disease and surgical correction. Cox proportional hazards regression was used to evaluate these variables. Short-term survival was not affected by any of the variables measured. For long-term survival with Kaplan-Meier statistics, horses ≥16years old had significantly shorter (P=.002) median survival times (72months; 95% CI 32.0-96.0) than younger horses (121.7months; 95% CI 90.0-162), horses without resection had significantly longer (P=.02) survival times (120months; 95% CI 86-212) than horses that had jejunocecostomy (76.8months; 95% CI 24-125), and horses with miscellaneous diseases had significantly longer (P=.02) median survival times (161.9months; 95% CI 72.0-M) than horses with strangulating lipoma (79.8months; 95% CI 32.0-120.0). In the multivariable Cox Proportional Hazard model, age (HR=2.67; 1.49-4.75, P<.001) and anastomosis (HR=0.65; 0.46-0.92, P=.02) had the most significant effect on median survival time. Limitations were small numbers in some categories, loss of cases to follow-up, owner recall failures and lack of a control group. The remaining lifespan of older horses at the time of surgery had the greatest effect on survival. Age could influence long-term survival studies after colic surgery, and therefore needs to be considered for survival analyses. Horses that did not require resection and anastomosis had favourable outcomes, underscoring the potential importance of early intervention to reduce the need for resection.

Jejunal strangulation and incarceration associated with bilateral perineal hernias in a neutered male dog

An 8-year-old 6.8-kg neutered male Dachshund was presented for evaluation of vomiting, diarrhea, anorexia, and swelling over the right perineal region. The dog had a history of a bilateral perineal herniorrhaphy and castration 14 months prior to presentation. Bilateral perineal hernias were confirmed by digital rectal examination. Abdominal ultrasonography confirmed the presence of intestine within the right hernia. Three days after admission to the hospital, the region of the right perineal hernia became painful, erythematous, and edematous. Computed tomography revealed jejunal incarceration within the right hernia with dilation of 1 jejunal segment that indicated intestinal obstruction. Abdominal exploratory surgery was performed, during which irreducible small intestinal incarceration was confirmed. Intra-abdominal jejunal resection and anastomosis was performed, and an approximately 13-cm-long section of the jejunum was resected. Bilateral perineal herniorrhaphies with internal obturator and superficial gluteal muscle transposition were performed. Six months after surgery, digital rectal examination of the dog revealed that the repair was intact. The dog had no perineal hernia-related clinical signs at the time of the recheck examination. For the dog of the present report, surgical management of small intestinal strangulation associated with a perineal hernia was successful. Although a portion of the small intestines can frequently be found within perineal hernias in dogs, perineal hernia-related small intestinal strangulation has not been previously described, to the authors' knowledge. Veterinarians and clients should be aware of this potential complication secondary to perineal hernia and be prepared to perform an abdominal surgical procedure to address small intestinal incarceration in affected dogs.

INCORRECT REPOSITIONING OF ENTRAPPED INGUINAL HERNIA

The case presents entrapped inguinal hernia and its incorrect repositioning with resulted strangulation of small intestine. The purpose of the work. Prevention of such cases in surgery and observance of strict rules of classical canons in the surgical environment, which remain relevant today. Patient M., 45 years old, was urgently hospitalized with complaints of intense, intractable, painful protrusion in the hernia in the right groin. From the anamnesis – suff ers from right inguinal hernia for 3 years. The day before, during exercise, an intractable, painful protrusion appeared at the site of the hernia, which began to increase. When examining the abdomen in the projection of the outer ring of the right inguinal canal there is a hernial protrusion, which does not disappear and does not change in size when changing body position. The protrusion is tense, dense, painful, the symptom of «coughing» in the area of protrusion is not transmitted, and coughing increases the pain. No free air and Kloiber’s bowls were found in the abdomen. According to laboratory and instrumental examination and objective signs, the diapatient was diagnosed with strangulated right inguinal hernia. During the examination of the patient, the hernial protrusion was exercised, so the patient was dynamically monitored. The next day the patient left the surgical department due to family circumstances. After 3 days, the patient again went to the surgical department with complaints of thirst and abdominal pain, vomiting with small intestine content and no discharge of gases and no bowel movements for 5 days. On examination, the patient’s condition is moderate. Taking into account the anamnesis, clinical evolution of the disease, laboratory and instrumental examination data and objective signs, it was concluded that the patient has acute surgical pathology. Diagnosed with: Acute small intestinal obstruction. The clinical case shows a misalignment of a strangulated inguinal hernia. After self-repositioning of the hernia, patients should be hospitalized to the surgical department for an elective surgery.

Strangulating lesions of the small intestine associated with the greater omentum in horses: 32 cases

SummaryBackgroundStrangulating lesions of the small intestine involving the greater omentum (SSIGOs) have only rarely been reported. Furthermore, information pertaining to clinical descriptions, surgical findings and outcome is lacking.ObjectivesThe objective of this study was to describe the prevalence, clinical presentation, surgical findings, postoperative outcome and risk factors associated with SSIGOs.Study designThis is a retrospective case series of 32 horses with a diagnosis of SSIGOs.MethodsData from hospital records of horses identified with SSIGOs between 2005 and 2020 including signalment, clinical findings at presentation, initial laboratory results, surgical findings, surgical procedures performed and postoperative survival were analysed. The prevalence of SSIGOs was determined. SSIGO was compared with small intestinal strangulating and nonstrangulating lesions and other types of colic to identify potential risk factors among signalment data and to determine outcome, using multiple logistic regression models.ResultsSSIGOs were present in 2.3% (32/1413) of all horses undergoing exploratory laparotomy for colic, 4.7% of all horses with primary small intestinal lesions (32/683) and 5.6% of strangulating small intestinal lesions (32/570). Surgical findings included primary strangulation by the greater omentum with or without involvement of a lipoma‐like mass originating from the greater omentum (15/32 [47%]), adhesions involving the greater omentum leading to strangulation of the small intestine (14/32 [44%]) and small intestine incarceration through an omental rent (3/32 [9%]). The short‐term survival rate defined as survival until discharge was 53% (17/32) considering all SSIGO cases, and 85% (17/20) for SSIGO cases recovered from anaesthesia. Risk factors identified were increasing age and year of surgery.Main limitationsThe limitations of this study are retrospective study design and the limited number of SSIGO cases reflecting the rarity of this condition.ConclusionsNumerous anatomical configurations of SSIGO exist, but clinical presentation is similar to other strangulating small intestinal lesions. Although uncommon, SSIGOs should be considered a potential cause of small intestine strangulation.

Hypothesis on the pathophysiology of small intestinal strangulation by a pedunculated lipoma

SummaryThe current hypothesis proposed for strangulation of small intestine by a pedunculated lipoma in horses involves movement of the lipoma around the small intestine until it loops through its own pedicle. This mechanism is difficult to demonstrate during surgical correction. The objective was to examine an alternative explanation for strangulation by pedunculated lipomas that is logical and consistent with intraoperative findings by the analysis of the anatomical features of 11 cases of lipoma strangulation in horses. In the proposed hypothesis, the stalk of the lipoma is tensed by the weight of the lipoma alone or by external forces on it from adjacent intestine. This produces a slit‐like aperture formed by the stalk and the contiguous mesentery. One or more loops of intestine pass across the lateral edge of the stalk before turning into this aperture, either because of lack of space in the abdominal cavity or through the effects of peristalsis. The weight of the intestine itself causes the loop to ‘fall’ into the aperture and become entrapped. This creates a half‐hitch knot in which the loop of intestine uses the lipoma pedicle as a ‘post’ around which it becomes strangulated. It was concluded that the proposed hypothesis differs from the existing one by requiring intestinal movement to create the strangulation, which is more plausible than the current proposal that the strangulation is caused by movement of the lipoma itself. It is also more consistent with surgical findings.

An atypical presentation of a mesenteric Meckel\u2019s diverticulum in a 7-year-old warmblood mare: case report

BackgroundMeckel’s diverticula are a rare cause of small intestinal strangulation, diagnosed at laparotomy or necropsy. This congenital anomaly of the gastrointestinal tract originates from a remnant of the vitelline duct. In reported equine cases, they present as a full-thickness diverticulum on the antimesenteric border of the distal jejunum or proximal ileum.Case presentationOn laparotomy a Meckel’s diverticulum positioned at the mesenteric side was found to be the cause of small intestinal strangulation. This position is very uncommon and to the best knowledge of the authors there is no unambiguous description of another case.ConclusionsMeckel’s diverticula should be on the list of differential diagnoses in cases of small intestinal strangulation. As in humans, equine Meckel’s diverticula can have the standard antimesenteric as well as a more exceptional mesenteric location. This case adds to the series of anecdotal reports of anomalies with regard to Meckel’s diverticula in the horse.

Ischaemic preconditioning and pharmacological preconditioning with dexmedetomidine in an equine model of small intestinal ischaemia-reperfusion.

Small intestinal strangulation associated with ischaemia-reperfusion injury (IRI) is common in horses. In laboratory animals IRI can be ameliorated by ischaemic preconditioning (IPC) and pharmacological preconditioning (PPC) with dexmedetomidine. The aim of this study was to determine the effect of PPC with dexmedetomidine or IPC in an equine model of small intestinal ischaemia-reperfusion (IR). In a randomized controlled experimental trial, 15 horses were assigned to three groups: control (C), IPC, and PPC with dexmedetomidine (DEX). All horses were placed under general anaesthesia and 90% jejunal ischaemia was induced for 90 minutes, followed 30 minutes of reperfusion. In group IPC, three short bouts of ischaemia and reperfusion were implemented, and group DEX received a continuous rate infusion of dexmedetomidine prior to the main ischaemia. Jejunal biopsies were collected before ischaemia (P), and at the end of ischaemia (I) and reperfusion (R). Mucosal injury was assessed by the Chiu-Score, inflammatory cells were stained by cytosolic calprotectin. The degree of apoptosis and cell necrosis was assessed by cleaved-caspase-3 and TUNEL. Parametric data were analyzed by two-way ANOVA for repeated measurements followed by Dunnetts t-test. Non parametric data were compared between groups at the different time points by a Kruskal-Wallis-Test and a Wilcoxon-2-Sample-test. The mucosal injury score increased during I in all groups. After reperfusion, IRI further progressed in group C, but not in IPC and DEX. In all groups the number of cleaved caspase-3 and TUNEL positive cells increased from P to I. The number of TUNEL positive cells were lower in group DEX compared to group C after I and R. Infiltration with calprotectin positive cells was less pronounced in group DEX compared to group C, whereas in group IPC more calprotectin positive cells were seen. In conclusion, IPC and DEX exert protective effects in experimental small intestinal ischaemia in horses.

Laparoscopic surgery for two patients with strangulated transomental hernias

BackgroundTransomental hernias are a rare type of internal hernia. We report two cases of successful cases of laparoscopic repair. One required laparotomy due to concern for intestinal viability.Case presentationThe first patient was a 67-year-old man who presented with abdominal pain and vomiting. He had no history of laparotomy or abdominal injury. Computed tomography suggested small bowel obstruction and possible intestinal strangulation. Emergent laparoscopy found approximately 200 cm of small bowel was strangulated around the greater omentum. The strangulation was released laparoscopically, but because of the color of the strangulated bowel, laparotomy was performed to evaluate viability. The involved portion of intestine was not resected. The patient experienced transient postoperative paralytic ileus and was discharged on postoperative day 14. The second patient was a 56-year-old man who presented with abdominal pain. Abdominal computed tomography revealed dilatation of the small intestine and a closed loop suggesting ileus due to intestinal strangulation. An emergency laparoscopy found a transomental hernia, and the strangulation was released laparoscopically. Recovery was uneventful, and the patient was discharged on postoperative day 6.ConclusionTransomental hernia can be successfully treated laparoscopically. In cases where bowel viability is a concern, laparotomy should not be hesitated.

Differences in plasma and peritoneal fluid proteomes identifies potential biomarkers associated with survival following strangulating small intestinal disease.

Strangulating small intestinal disease (SSID) carries a poor prognosis for survival in comparison to other types of colic, particularly if resection is required. Identification of markers which aid early diagnosis may prevent the need for resection, assist with more accurate prognostication and/or support the decision on whether surgical intervention is likely to be successful, would be of significant welfare benefit. To apply an unbiased methodology to investigate the plasma and peritoneal fluid proteomes in horses diagnosed with SSID requiring resection, to identify novel biomarkers which may be of diagnostic or prognostic value. Prospective clinical study. Plasma and peritoneal fluid from horses presented with acute abdominal signs consistent with SSID was collected at initial clinical examination. Samples from eight horses diagnosed with SSID at surgery in which resection of affected bowel was performed and four control horses subjected to euthanasia for orthopaedic conditions were submitted for liquid chromatography tandem mass spectrometry. Protein expression profiles were determined using label-free quantification. Data were analysed using analysis of variance to identify differentially expressed proteins between control and all SSID horses and SSID horses which survived to hospital discharge and those which did not. Significance was assumed at P≤0.05. A greater number of proteins were identified in peritoneal fluid than plasma of both SSID cases and controls, with 123 peritoneal fluid and 13 plasma proteins significantly differentially expressed (DE) between cases and controls (P<0.05, ≥2 fold change). Twelve peritoneal fluid proteins (P<0.036) and four plasma proteins (P<0.05) were significantly DE between SSID horses which survived and those which did not. A low number of samples were analysed, there was variation in duration and severity of SSID and only short-term outcome was considered. Changes in peritoneal fluid proteome may provide a sensitive indicator of small intestinal strangulation and provide biomarkers relevant to prognosis.

Intramurales Lipom im Jejunum als Ursache für eine Invagination bei einer jungen Araberstute

A 2-year-old Arabian horse was presented with severe colic symptoms. During explorative laparotomy, a jejuno-jejunal invagination secondary to a submucosal intestinal mass was detected. The involved jejunal segment was surgically removed and an end-to-end anastomosis was created. Opening the specimen demonstrated the presence of a nodular mass on the head of the intussusceptum, measuring 10 cm in diameter, and almost completely obliterating the intestinal lumen. Additionally, a severe hyperemia of the jejunal mucosa was visible. Histological examination, which revealed a well-demarcated mass in the submucosa of the jejunum consisting of well-differentiated adipocytes, led to the diagnosis of an intramural lipoma. The small intestinal mucosa displayed mild to moderate signs of congestion. Pedunculated lipomas in the mesentery of horses causing intestinal volvulus and obstruction are a frequent cause of small-intestine strangulation in aged horses. To the authors' knowledge, intramural intestinal lipomas to date have not been described in the horse. The mare recovered without complications and was free of colic symptoms after 6 months.

MORPHOLOGICAL CHANGES OF THE SMALL INTESTINE IN ACUTE STRANGULATIVE INTESTINAL OBSTRUCTION IN THE STAGE OF DECOMPOSITION IN CHILDREN

Purpose. The purpose was to determine the depth and prevalence of pathomorphological changes in the small intestine of children at the distance from the visible border of necrosis with decompensated acute strangulated intestinal obstruction (ASIO) to determine the minimum possible length of intestinal resection.Material and methods. Morphological studies of a resected fragment of the small intestine were performed in 24 children aged 3 days to 18 years who had undergone a surgery for ASIO with intestinal necrosis. Strangulated adhesive obstruction was found in 17 children, five children had congenital intestine torsion and two children faced small intestinal strangulation in the congenital mesenteric defect. The postsurgical material was studied morphologically using histological stains with the distance of 3 cm between the section.Results. The depth, prevalence of the morphological changes in the small intestinal wall, intensity and length of morphological changes in children with decompensated ASIO were determined.Conclusion. A differentiated approach to the selection of resection scope in the proximal and distal directions from the visible border of ASIO-related necrosis is necessary. The distances are twice shorter in children as compared to adults. Refusal from extensive resections will enable to reduce the rate of short bowel syndrome in children.

Correlation of epiploic foramen length to height, weight, breed, gender and age in horses

SummaryEpiploic foramen entrapment (EFE) is one of the most common causes of small intestinal strangulation in horses. Cribbing and previous episodes of colic are suggested as risk factors for its occurrence. The aim of this study was to correlate the height, weight, breed, gender and age to the epiploic foramen (EF) length. Forty‐three horses were submitted to post‐mortem measurement of epiploic foramen with abdominal and thoracic organs positioned in situ. After data collection, linear regression between EF length and the explanatory variables was performed. None of the post‐mortem physical variables was associated with EF length, supporting the hypothesis that there is no association between EF length and age, and that increased intra‐abdominal pressure is the most important factor predisposing to EFE recurrence.

Strangulation of the small intestine caused by an intra-mesosigmoid hernia: a case report

Sigmoid mesocolon hernia is an uncommon type of internal hernia with only a few cases reported to date. This disease entity can progress rapidly to cause vascular disturbance, necrosis, and perforation of the bowel wall; therefore, early diagnosis and surgical treatment are essential. We describe the case of an intra-mesosigmoid hernia in a 60-year-old man without history of previous abdominal surgery who presented with sudden acute abdominal pain and vomiting. Based on computed tomography, which showed ascites and small bowel obstruction, we diagnosed him as having strangulation of the small intestine caused by a sigmoid mesocolic hernia and performed emergency surgery. Laparotomy revealed small intestinal strangulation, extensive engorgement, and discoloration of bowel loops. Approximately 100 cm of the small intestine extending from the ligament of Treitz had undergone strangulation and herniated into the defect of sigmoid mesocolon, leading to a diagnosis of an intra-mesosigmoid hernia. Because the incarcerated portion of the small intestine was viable, we did not perform intestinal resection and reconstruction but closed the defect in the sigmoid mesocolon. His postoperative course was uneventful.