Descending mesocolon defect herniation: case report

Internal hernia, herniation of the internal organs through defects in the intraabdominal cavity, is rare. Due to the rarity of this pathology and lack of the specific symptoms and signs, early diagnosis and treatment are always stressful to the clinician and misdiagnoses may occur in the emergency room. The prognosis of a patient with uncomplicated internal hernia is excellent. We report a 21-year-old Chinese man with internal herniation through a defect of mesocolon, presented as an impalpable abdominal mass which was shown only on imaging studies. In addition to the typical whirlpool pattern, a huge solid mass between the pancreatic tail and stomach was found under computed tomography (CT) scan. The major symptoms were intermittent epigastralgia and abdominal fullness that had bothered him for years. Physical examination results showed only mild epigastric tenderness. Computed tomography scans and exploratory laparotomy of the abdomen played vital roles during diagnosis. The herniated organ was a portion of jejunum with partial small intestinal obstruction.