Geriatric spontaneous trans-mesenteric herniation leading to death. Case report

Area of Science:

• Gastroenterology
• Surgical Case Reports

Background:

• Spontaneous trans-mesenteric hernia is a rare condition in adults.
• Pre-operative diagnosis is challenging, even with advanced imaging like Computed Tomography Scanning.
• Most cases are discovered incidentally during surgery or postmortem.

Observation:

• A case report details a geriatric patient presenting with intestinal obstruction.
• Intra-operative findings revealed strangulated, gangrenous small bowel due to a large trans-mesenteric defect.
• Despite surgical intervention, the patient unfortunately succumbed post-operatively.

Findings:

• Spontaneous trans-mesenteric hernia is a difficult-to-diagnose cause of small bowel obstruction.
• The condition frequently leads to bowel ischemia due to strangulation.
• Delayed diagnosis significantly increases morbidity and mortality rates.

Implications:

• A high index of suspicion is essential for surgeons and radiologists when evaluating intestinal obstruction.
• Considering spontaneous trans-mesenteric hernia in the differential diagnosis is vital, even without typical predisposing factors.
• Prompt diagnosis and intervention are critical to improve outcomes and reduce mortality in these rare cases.