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Murine Ileocolic Bowel Resection with Primary Anastomosis
Published on: October 29, 2014
Post-operative transmesosigmoid hernia causing small bowel obstruction: a case report
Robleh Hassan Farah1, Yassine Fahmi1, Driss Khaiz1
1Service des Urgences Chirurgicales Viscérales, Centre Hospitalier Universitaire Ibn Rochd, Casablanca, Morocco.
Abstract:
Internal hernia is an unusual cause of small bowel obstruction and classified several types according to locations. Transmesosigmoid hernia is rare type among others mesosigmoid hernia was rarely reported in the literature. We report the case of a 44-year-old male who presented with acute abdominal pain and developed a small intestinal obstruction. History, clinical and radiography examination were suggested intestinal obstruction due to postoperative adhesion. The diagnosis of small bowel obstruction due to internal hernia was confirmed by laparotomy exploration. The herniated loop was reduced successfully and the defect was approximated with interrupted sutures. The postoperative course was uneventful and the patient is free from symptoms and recurrence. This case report highlight difficulty and importance of high index of suspicion considering an internal hernia as a cause of small bowel obstruction in individuals of all age groups with or without a previous history of abdominal surgery.
Insights
Internal hernia, a rare cause of small bowel obstruction, can occur even without prior abdominal surgery. Prompt diagnosis and surgical repair lead to successful outcomes and symptom resolution.
Area of Science:
- Gastroenterology
- Surgical Case Reports
Background:
- Internal hernia is an uncommon etiology of small bowel obstruction.
- Transmesosigmoid hernia represents a rare subtype, with limited literature documenting its occurrence.
Observation:
- A 44-year-old male presented with acute abdominal pain and signs of small intestinal obstruction.
- Initial assessment suggested postoperative adhesions, but laparotomy revealed an internal hernia as the cause.
Findings:
- The internal hernia was successfully reduced during laparotomy.
- The mesenteric defect was closed with interrupted sutures, resolving the obstruction.
Implications:
- This case underscores the importance of considering internal hernia in all patients with small bowel obstruction, regardless of surgical history.
- A high index of suspicion is crucial for timely diagnosis and effective management of this rare condition.

