Small bowel obstruction caused by sigmoid mesocolic hernia

Area of Science:

• Gastroenterology and Hepatology
• Surgical Gastroenterology
• Abdominal Imaging

Background:

• Internal hernias, though uncommon, are a significant cause of small bowel obstruction.
• Sigmoid mesocolic hernias, particularly intramesosigmoid hernias, are exceptionally rare congenital anomalies.
• Accurate diagnosis and appropriate surgical management are crucial for favorable outcomes.

Observation:

• A 49-year-old female presented with symptoms of small bowel obstruction.
• Computed tomography suggested an internal hernia, later confirmed intraoperatively as an intramesosigmoid hernia.
• The patient had no prior history of abdominal surgery.

Findings:

• A rare congenital intramesosigmoid hernia was identified as the cause of obstruction.
• Laparoscopic exploration confirmed the diagnosis and allowed for surgical intervention.
• The surgical technique involved detachment of the peritoneal attachment forming the hernia sac, without defect repair.

Implications:

• This case highlights the successful laparoscopic management of a rare intramesosigmoid hernia.
• The described surgical approach offers a viable alternative for treating specific types of internal hernias.
• Early diagnosis via advanced imaging and prompt surgical intervention are key to resolving obstructive symptoms and preventing recurrence.