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Multimodality Diagnosis of Mesenteric Ischemia
Published on: July 21, 2023
Mesenteric appendicitis strangulating small bowel: an exceptional internal herniation
1Department of General Surgery, Cadi Ayyad University, Marrakesh, Morocco. y.narjis@yahoo.fr
Abstract:
Primitive internal hernias are a rare cause of intestinal obstruction. They are often paraduodenal even transmesocolic, but only rarely transomental. We present a rare case of an internal abdominal hernia in a young man. The small bowel was strangulated by an intra mesenteric appendicitis. This hernia was revealed by abdominal pain, nausea and vomiting. Plain X-ray of the abdomen showed dilated jejunal and ileal loops with multiple air-fluid levels. The diagnosis of appendicitis was suggested by ultrasound but the internal hernia was found only upon surgical exploration. An appendicectomy and adhesiolysis were performed. The patient recovered fully after 3 days, and had an uneventful postoperative course. The authors discuss the possible cause of this rare intestinal obstruction.
Insights
A rare internal abdominal hernia caused by intra-mesenteric appendicitis led to small bowel strangulation in a young man. Surgical exploration revealed the hernia, leading to successful appendicectomy and adhesiolysis for full recovery.
Area of Science:
- Gastroenterology
- Abdominal Surgery
- Radiology
Background:
- Internal hernias, though rare, are a significant cause of intestinal obstruction.
- Transomental hernias are exceptionally uncommon types of internal abdominal hernias.
Observation:
- A young male presented with abdominal pain, nausea, and vomiting, indicative of intestinal obstruction.
- Abdominal X-rays revealed dilated small bowel loops with air-fluid levels.
- Ultrasound suggested appendicitis, but the internal hernia was only diagnosed during surgery.
Findings:
- The case involved a rare transomental internal hernia.
- The small bowel was found to be strangulated by an intra-mesenteric appendicitis.
- Surgical intervention included appendicectomy and adhesiolysis.
Implications:
- This case highlights the importance of considering rare causes of intestinal obstruction.
- Intra-mesenteric appendicitis can present as a cause of internal hernia and strangulation.
- Prompt surgical diagnosis and management are crucial for favorable outcomes in such rare cases.
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