Obstruction of the Bowel on an Inter-sigmoid Hernia: A Rare Cause of Occlusion

Inter-sigmoid hernia is a rare condition characterized by the protrusion of the small intestine into the inter-sigmoid fossa. The inter-sigmoid fossa, also known as the inter-sigmoid recess, is a funnel-shaped peritoneal pouch of variable size, located between the two mesenteric roots of the parietal margin of the meso-sigmoid. The diagnosis of inter-sigmoid hernia is often delayed due to nonspecific clinical symptoms, which frequently leads to a postponement of surgical intervention. Preoperative detection on CT imaging can be challenging, and the diagnosis is typically confirmed during urgent surgical exploration. We report the case of a 63-year-old man who presented to the emergency room with abdominal pain. The physical examination and radiological findings were suggestive of an intestinal occlusion over an internal hernia. Given these findings, an emergency laparotomy was performed, confirming the diagnosis of an inter-sigmoid internal hernia with incarceration of a distended segment of the small intestine.