Congenital and acquired mesocolic hernias presenting with small bowel obstruction in childhood and adolescence

Area of Science:

• Pediatric Surgery
• Gastrointestinal Surgery
• Diagnostic Imaging

Background:

• Internal mesocolic hernias are rare causes of small bowel obstruction in children.
• These hernias can be congenital or acquired, often associated with prior abdominal surgery or anomalies.

Purpose of the Study:

• To present a case series of pediatric patients with small bowel obstruction caused by internal mesocolic hernias.
• To highlight the role of imaging technology in diagnosing and managing this condition.

Main Methods:

• Retrospective review of 6 pediatric patients treated for small bowel obstruction secondary to internal mesocolic hernias between 1998 and 2008.
• Analysis of patient demographics, hernia type (congenital vs. acquired), diagnostic methods, and clinical outcomes.

Main Results:

• Six cases of small bowel obstruction due to internal mesocolic hernias (4 congenital, 2 acquired) were identified.
• Preoperative computerized tomography (CT) diagnosed 50% of cases; the remainder were diagnosed intraoperatively.
• The median patient age was 13 years, with a mean hospital stay of 6 days and no recurrences.

Conclusions:

• Small bowel obstruction from mesocolic hernias, though uncommon, should be considered in pediatric patients with a history of malrotation or abdominal wall defects.
• Accurate clinical diagnosis is challenging, making imaging studies essential for prompt identification and management.
• Early recognition and intervention are critical due to the potentially severe consequences of this condition.