Transmesenteric hernia with two mesenteric defects in an adult

Area of Science:

• Gastroenterology
• Surgical Case Reports
• Abdominal Surgery

Background:

• Transmesenteric hernia is an uncommon cause of small bowel strangulation in adults.
• Multiple mesenteric defects are exceptionally rare, with no prior reports in adult patients.

Observation:

• A 73-year-old woman presented with abdominal pain and nausea, diagnosed via CT scan with a pelvic closed-loop obstruction.
• Exploratory laparotomy confirmed small bowel strangulation due to a transmesenteric hernia.
• A second, previously undetected mesenteric defect was identified during intraoperative examination.

Findings:

• The patient had two distinct mesenteric defects.
• Both defects were successfully repaired with sutures during the same operation.
• The patient experienced a satisfactory postoperative recovery.

Implications:

• This case highlights the importance of a comprehensive intraoperative examination of the entire mesentery to identify all potential defects.
• Thorough inspection can prevent recurrence of internal hernias after surgical repair.
• Awareness of multiple mesenteric defects is important for surgeons managing internal hernias.