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Laparoscopic Repair of Internal Transmesocolic Hernia of Transverse Colon
Tomokazu Kishiki1, Toshiyuki Mori1, Yoshikazu Hashimoto1
1Department of Surgery, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka City, Tokyo 181-8611, Japan.
Insights
This case report details a rare transmesocolic internal hernia of the transverse colon. Early diagnosis via CT and laparoscopic surgery led to a successful patient outcome with no complications.
Area of Science:
- Gastroenterology
- Surgical Innovation
- Abdominal Imaging
Background:
- Internal hernias are uncommon and frequently misdiagnosed, leading to increased patient morbidity.
- Transmesocolic hernias, particularly those involving the transverse colon, are exceptionally rare.
- Distinguishing transmesocolic hernias from other internal hernias like paraduodenal hernias can be challenging.
Purpose of the Study:
- To report a case of transmesocolic internal hernia of the transverse colon.
- To highlight the diagnostic utility of computed tomography (CT) in identifying internal hernias.
- To demonstrate the feasibility and efficacy of laparoscopic surgery for this rare condition.
Main Methods:
- A 61-year-old male patient presented with intermittent abdominal pain.
- Computed tomography (CT) scan was performed, suggesting a transmesocolic internal hernia.
- Laparoscopic surgical exploration and repair were conducted.
Main Results:
- The patient was diagnosed with a transmesocolic internal hernia involving a small intestine loop through a defect in the transverse mesocolon.
- No signs of strangulation were observed.
- The laparoscopic procedure was completed successfully, with an uneventful postoperative recovery and discharge on postoperative day 6.
Conclusions:
- Transmesocolic hernias of the transverse colon are rare, but CT imaging aids in preoperative diagnosis.
- Laparoscopic surgery is a viable and effective treatment option for transmesocolic internal hernias.
- Prompt diagnosis and surgical intervention are crucial for managing internal hernias and preventing complications.
Abstract:
Introduction. Internal hernias are often misdiagnosed because of their rarity, with subsequent significant morbidity. Case Presentation. A 61-year-old Japanese man with no history of surgery was referred for intermittent abdominal pain. CT suggested the presence of a transmesocolic internal hernia. The patient underwent a surgical procedure and was diagnosed with transmesocolic internal hernia. We found internal herniation of the small intestine loop through a defect in the transverse mesocolon, without any strangulation of the small intestine. We were able to complete the operation laparoscopically. The patient's postoperative course was uneventful and the patient was discharged on postoperative day 6. Discussion. Transmesocolic hernia of the transverse colon is very rare. Transmesocolic hernia of the sigmoid colon accounts for 60% of all other mesocolic hernias. Paraduodenal hernias are difficult to distinguish from internal mesocolic transverse hernias. We can rule out paraduodenal hernias with CT. Conclusion. The patient underwent a surgical procedure and was diagnosed with transmesocolic internal hernia. We report a case of a transmesocolic hernia of the transverse colon with intestinal obstruction that was diagnosed preoperatively and for which laparoscopic surgery was performed.
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