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Published on: September 11, 2018

Internal hernias in children: spectrum of clinical and imaging findings

Vivian Tang1, Alan Daneman, Oscar M Navarro

  • 1Department of Medical Imaging, University of Toronto, Toronto, ON, Canada.

Pediatric Radiology
|July 8, 2011
PubMed

Insights

Internal hernias (IH) in children present diverse symptoms and imaging results. Paraduodenal hernias are visible on UGI series, while transmesenteric hernias are harder to detect, requiring a high suspicion for diagnosis.

Area of Science:

  • Pediatric Surgery
  • Pediatric Radiology
  • Gastrointestinal Imaging

Background:

  • Internal hernias (IH) are rare in pediatric populations.
  • Clinical and imaging characteristics of pediatric IH are not well-documented.

Purpose of the Study:

  • To define the range of clinical and imaging findings for internal hernias in children.
  • To identify key diagnostic features of pediatric internal hernias.

Main Methods:

  • Retrospective review of 12 pediatric patients with surgically confirmed internal hernias.
  • Analysis of clinical presentation, imaging studies, and surgical outcomes.

Main Results:

  • Internal hernias occurred in 7 girls and 5 boys, with 5 neonates and 7 older children (8-17 years).
  • Neonatal cases involved acute presentations and transmesenteric internal hernias (TMIH), with limited visualization on GI contrast studies.
  • Older children had paraduodenal hernias (congenital) or TMIH (acquired), with paraduodenal hernias easily diagnosed on UGI series.
  • Associated malrotation was noted in 70% of congenital IH, particularly right paraduodenal hernias.

Conclusions:

  • Pediatric internal hernias exhibit varied clinical and imaging presentations.
  • Transmesenteric internal hernias are challenging to visualize with GI contrast, unlike paraduodenal hernias.
  • A high index of suspicion for right paraduodenal hernia is crucial when UGI series show duodenal and small bowel displacement to the right of the spine.
Abstract

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