Internal hernia through an idiopathic transverse mesocolon defect treated by laparoscopic surgery: a case report

Internal hernia is a rare cause of intestinal obstruction, and transverse mesocolon hernia (TMH) is an extremely rare subtype of internal hernia.

We report the successful treatment of a TMH through an idiopathic transverse mesocolon defect (iTMD). A 50-year-old man was rushed to hospital with sudden onset of abdominal pain. Computed tomographic imaging showed an internal hernia with small bowel obstruction in the right upper abdomen. He underwent emergency surgery for suspected strangulated intestinal obstruction caused by internal hernia. Laparoscopic surgery revealed that the small intestine was incarcerated in the iTMD. The incarcerated small intestine was reduced without requiring resection, and the iTMD was closed with barbed suture.

TMHs are rare and often difficult to diagnose preoperatively. Early recognition using characteristic computed tomographic findings can facilitate timely laparoscopic intervention and avoid complications such as bowel necrosis.

Idiopathic TMH should be considered as a differential diagnosis in patients with an internal hernia and no history of surgery.