Small bowel obstruction secondary to a pericecal hernia in an adult patient, an extremely rare condition
Jorge Sancho-Muriel1, Hanna Cholewa1, David Abelló1
1Colorectal Unit, Hospital Universitario y Politécnico la Fe, Valencia, Spain.
Abstract:
Internal hernias are defined by the protrusion of an abdominal organ through a peritoneal or mesenteric aperture. They are responsable for up to 5.8% of all small bowel obstructions (SBOs). Pericecal hernia is a highly unusual variation. We present a case of a 17-year-old Asian male turned to the emergency department due to abrupt abdominal pain and peritonitis. An emergent laparotomy revealed a small bowel herniation through the avascular space of Treves with small bowel necrosis. A pericecal hernia is an extremely unusual clinical entity; however, it should be considered in the differential diagnosis of SBO.
Insights
Internal hernias, including rare pericecal types, can cause small bowel obstructions. This case highlights the importance of considering these unusual hernias in emergency diagnoses.
Area of Science:
- Gastroenterology
- Surgical Anatomy
- Abdominal Imaging
Background:
- Internal hernias account for up to 5.8% of small bowel obstructions.
- Pericecal hernia, a specific type, is exceptionally rare.
- Early diagnosis and surgical intervention are crucial for managing small bowel obstructions.
Observation:
- A 17-year-old male presented with acute abdominal pain and peritonitis.
- Physical examination revealed signs suggestive of an acute abdominal process.
- Diagnostic imaging, though not detailed in the abstract, is typically used to evaluate suspected hernias.
Findings:
- Emergent laparotomy confirmed a small bowel herniation through the avascular space of Treves.
- Small bowel necrosis was identified, indicating compromised blood supply.
- The herniation was consistent with a pericecal hernia.
Implications:
- Pericecal hernias, though rare, must be included in the differential diagnosis for small bowel obstruction.
- Prompt surgical evaluation is essential for patients with suspected internal hernias.
- Understanding rare anatomical variations is key to successful surgical outcomes.
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