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An unusual case of intestinal obstruction due to internal herniation from adhesions between two appendices epiploicae

K N Srivastava1, Amit Agarwal1, Damarakuppam Roopesh1

  • 1Department of General and Minimal Access Surgery, BL Kapur Superspeciality Hospital, New Delhi, India.

Journal of Surgical Case Reports
|September 18, 2018
PubMed

Insights

Internal small bowel herniation through appendices epiploicae is exceptionally rare in non-operated abdomens. Early surgical intervention is crucial for managing this rare cause of intestinal obstruction.

Area of Science:

  • Gastroenterology
  • Surgical Pathology

Background:

  • Internal hernias are uncommon, particularly in patients without prior abdominal surgery.
  • Herniation involving appendices epiploicae is exceedingly rare, with fewer than five cases documented.

Observation:

  • A 75-year-old male presented with internal herniation of the small bowel.
  • The hernia occurred through an aperture formed by adhesions between two appendices epiploicae in a previously unoperated abdomen.

Findings:

  • Successful management was achieved through laparotomy and division of the adhesion.
  • This case highlights a unique etiology for internal hernia in a virgin abdomen.

Implications:

  • A high index of suspicion is vital for diagnosing internal hernias, even in unusual presentations.
  • Prompt surgical intervention can significantly reduce mortality and morbidity associated with intestinal obstruction due to rare causes.

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