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Internal Hernia Through a Mesoappendix Defect: A Case Report and Review of the Literature

Rafique Umer Harvitkar1, Sugunesh Nanjan2, Ioannis Hannadjas1

  • 1General Surgery, Royal Sussex County Hospital, Brighton, GBR.

Cureus
|March 24, 2025
PubMed

Insights

A rare case of internal hernia through a mesoappendix defect caused small bowel obstruction (SBO) in a 76-year-old woman. Prompt diagnosis and surgical reduction led to an uneventful recovery, underscoring the importance of considering rare hernias in SBO diagnosis.

Area of Science:

  • Gastroenterology
  • Surgical Pathology

Background:

  • Internal hernias are infrequent causes of small bowel obstruction (SBO), potentially leading to severe complications if not managed promptly.
  • Herniation through a mesoappendix defect is a particularly rare form of internal hernia, with limited documented cases.

Observation:

  • A 76-year-old female presented with acute lower abdominal pain, nausea, vomiting, and distension.
  • Diagnostic imaging indicated a partial SBO with two transition points.
  • Laparoscopy revealed proximal ileum herniating through a mesoappendix defect, causing a closed-loop obstruction.

Findings:

  • The herniated small bowel was viable and successfully reduced.
  • An appendicectomy was performed following the reduction.
  • The patient experienced an uncomplicated postoperative recovery.

Implications:

  • This case emphasizes the necessity of including internal hernias in the differential diagnosis for patients presenting with SBO.
  • Even in patients with a history of abdominal surgeries, rare internal hernias should be considered.
  • Early recognition and surgical intervention are crucial for favorable outcomes in mesoappendiceal defects causing SBO.
Keywords:
closed loop obstructioninternal hernialaparoscopymesoappendixsmall bowel obstruction

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