[Internal hernia through Treves' avascular field defect (author's transl)]

Area of Science:

• Pediatric Surgery
• Gastrointestinal Surgery
• Anatomy

Background:

• Internal hernias through Treves avascular field defects are exceedingly rare, particularly in pediatric surgical practice.
• These defects represent uncommon anatomical variations that can predispose to internal herniation.

Observation:

• Three cases of internal hernia at the ileal level through Treves avascular defects are presented.
• One case was incidentally discovered during surgery for adhesive intestinal obstruction, potentially linked to a prior neonatal obstruction.
• The clinical presentation mimicked intestinal strangulation, making preoperative diagnosis difficult.

Findings:

• The study details surgical management and outcomes for these rare internal hernias.
• Resection extending to the cecum was considered to mitigate vascular risks at the anastomosis, even with ileocecal valve sacrifice.
• All three patients experienced successful outcomes and survived.

Implications:

• This condition poses significant diagnostic challenges in pediatric surgery due to its rarity and nonspecific presentation.
• Surgical intervention requires careful consideration of anatomical defect and potential complications.
• Understanding these rare defects is crucial for accurate diagnosis and effective management of pediatric intestinal obstructions.