Surgical Management of Pericaecal Hernia in a Virgin Abdomen

Internal hernia is an uncommon cause of mechanical small bowel obstruction. This case report details a 66-year-old Chinese male with no prior abdominal surgeries who presented with colicky abdominal pain, abdominal distension, and vomiting. Initial investigations were unyielding, but escalating symptoms prompted a diagnostic laparoscopy. Laparotomy then revealed a closed-loop obstruction through a lateral type pericecal hernia, with a segment of ischemic jejunum. Adhesion bands in the right iliac fossa and a congenital hernia orifice in the mesentery were identified and addressed. The patient recovered well postoperatively. This discussion explores the Meyer's classification of pericecal hernias, potential etiologies, clinical manifestations, diagnostic considerations, and the choice between laparoscopic and open surgeries. This case underscores the importance of a high index of suspicion, prompt surgical intervention, and the diagnostic utility of laparoscopy in managing pericecal hernias.