Internal hernia through mesoappendix causing small bowel obstruction: A case report

Area of Science:

• Gastroenterology
• Surgical Anatomy

Background:

• Intestinal obstruction is a frequent cause of acute abdomen requiring surgical intervention.
• Internal hernias are an uncommon cause of intestinal obstruction, accounting for less than 1% of cases.
• Herniation through the mesoappendix is exceptionally rare, with few documented instances.

Observation:

• A 50-year-old male presented with symptoms and signs consistent with small bowel obstruction (SBO).
• Intraoperative diagnosis revealed an internal hernia through the mesoappendix as the cause of SBO.
• The patient was treated with appendectomy and hernia release.

Findings:

• Trans-mesoappendicular internal hernia is an extremely rare cause of SBO.
• The etiology of trans-mesoappendicular hernias is not fully understood, but congenital defects in the mesoappendix may play a role.
• Internal hernias should be included in the differential diagnosis for acute intestinal obstruction, especially in patients without prior surgical history.

Implications:

• This case underscores the need for heightened clinical suspicion for rare causes of SBO.
• Accurate and timely diagnosis of internal hernias is crucial for appropriate surgical management.
• Further research into the pathogenesis of mesoappendiceal hernias may improve diagnostic and therapeutic strategies.