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Intestinal obstruction in a patient with congenital transverse mesocolic defect with internal hernia: A case report

Samrat Shrestha1, Suresh Maharjan1, Bijay Raj Bhatta1

  • 1National Academy of Medical Sciences, NAMS, Bir Hospital, Department of General Surgery, Kathmandu, Province-3, Nepal.

International Journal of Surgery Case Reports
|March 9, 2025
PubMed

Insights

Congenital transverse mesocolic defects causing internal hernias are rare but serious. Prompt diagnosis and surgical repair are crucial for favorable outcomes in patients with unexplained bowel obstruction.

Area of Science:

  • Gastroenterology
  • Abdominal Surgery
  • Radiology

Background:

  • Internal hernias (IH) represent 5.8% of intestinal obstructions.
  • Congenital transverse mesocolic defects are a rare cause of IH, posing diagnostic and surgical challenges.

Observation:

  • A 71-year-old female with COPD presented with symptoms of acute intestinal obstruction.
  • Contrast-enhanced computed tomography (CECT) identified a transition point, leading to exploratory laparotomy.
  • A 7x6 cm defect in the transverse mesocolon was found, with ileal loops herniated into the lesser sac.

Findings:

  • Surgical reduction of the herniated bowel and closure of the transverse mesocolic defect were performed.
  • The patient recovered well postoperatively without complications.

Implications:

  • Congenital transverse mesocolic internal hernias (TMIH) should be considered in atypical cases of unexplained bowel obstruction.
  • Early diagnosis via imaging and timely surgical intervention are key to successful management of TMIH.
Abstract

Keywords:
Case reportCongenitalInternal herniaIntestinal obstructionLaparotomyTransverse mesocolic hernia

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