Ileal herniation into a sigmoid colon epiploic fat foramen extrasigmoid hernia

Internal abdominal hernia (IAH) is defined as protrusion of viscus through a peritoneal or mesenteric aperture, leading to its encapsulation within another compartment in the abdominal cavity. Herein we report a rare case of small bowel obstruction due to herniation with incarceration of a loop of ileum into a foramen formed by the epiploic fat of the sigmoid colon due to a non-specific inflammatory process; this may be defined as extrasigmoid hernia. To our knowledge, there has been no previous report of this type of IAH in the English literature. In summary, an acute intestinal obstruction with strangulation in the absence of an external hernia without previous operation suggests the possibility of internal hernia, especially if the patient has a history of intermittent abdominal distress.