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Updated: Jun 27, 2025
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A Murine Model of Irreversible and Reversible Unilateral Ureteric Obstruction
Published on: December 20, 2014
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Large Bowel Internal Hernia Secondary to Reimplanted Ureter
Amy A Howk1, Anna Hayden2, John E Griepentrog1
1Department of General Surgery, University of Tennessee Medical Center, Knoxville, TN, USA.
Case Reports in Surgery
|May 8, 2024
Summary
Internal hernias, often missed on imaging, can cause bowel obstruction. This case highlights how altered anatomy after surgery can lead to colon herniation, requiring surgical intervention.
Area of Science:
- Gastroenterology
- Surgical Anatomy
- Diagnostic Imaging
Background:
- Internal hernias are challenging to diagnose clinically, with normal cross-sectional imaging reported in many cases.
- Transmesenteric hernias are frequently associated with congenital defects or previous abdominal surgeries.
Observation:
- A 46-year-old female presented with acute nausea and vomiting eight years post-laparoscopic hysterectomy with ureteral reimplantation.
- Rectal contrast CT scan revealed a partial large bowel obstruction, with etiology uncertain (mass, stricture, or internal herniation).
Findings:
- Exploratory laparotomy identified redundant transverse colon herniated under a mobile right ureter.
- An extended right hemicolectomy was performed to address the internal herniation.
Implications:
- Altered retroperitoneal anatomy post-surgery can create spaces predisposing to colonic herniation.
- High clinical suspicion is crucial for patients with obstructive symptoms, especially after abdominal procedures.
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