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A transmesenteric congenital internal hernia presenting in an adult

Hellen McK Edwards1, Haytham Al-Tayar2

  • 1Department of Obstetrics and Gynecology, Herlev Hospital, Herlev, Denmark hellenedwards@yahoo.com.

Journal of Surgical Case Reports
|June 27, 2014
PubMed

Insights

Congenital internal hernias (CIAHs) are a rare cause of small bowel obstruction. This case highlights a transmesenteric CIAH successfully repaired via laparotomy, with the patient recovering quickly.

Area of Science:

  • Gastroenterology
  • Abdominal Surgery
  • Radiology

Background:

  • Congenital internal hernias (CIAHs) represent a rare etiology of small bowel obstruction in adult populations.
  • Diagnosis can be challenging, often requiring advanced imaging and surgical exploration.

Observation:

  • A 32-year-old male presented with symptoms suggestive of intestinal obstruction.
  • Clinical examination and computed tomography (CT) scan indicated obstruction, but the specific cause remained unclear.

Findings:

  • Emergency laparotomy revealed a transmesenteric congenital internal hernia.
  • Approximately 1 meter of small bowel had herniated through a 2 cm mesenteric defect near the transverse colon.
  • The mesenteric defect was successfully repaired using interrupted sutures.

Implications:

  • This case underscores the importance of considering CIAH in the differential diagnosis of adult small bowel obstruction.
  • Prompt surgical intervention and repair of mesenteric defects are crucial for favorable patient outcomes.
  • Accurate preoperative diagnosis via CT imaging can aid in surgical planning for these rare hernias.

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