A novel technique of laparoscopic reduction of incarcerated internal supravesical hernia via peritoneal incision: A case report

A 51-year-old male was presented with abdominal pain and vomiting. Contrast-enhanced computed tomography showed a dilated small intestine with a sac-like appearance in the right lower abdomen. An internal hernia in the inguinal area was found during emergency laparoscopic exploration. The incarcerated small intestine was gently reduced, and the internal hernia sac was located in the right medial inguinal fossa. An indirect inguinal hernia was identified just behind the dissected internal hernia sac. The internal hernia sac was resected, and the indirect inguinal hernia was repaired through a transabdominal preperitoneal approach. The patient had no recurrence of hernia within the 20 months of follow-up after the surgery. This is the first case of an internal hernia in the medial inguinal fossa with a concurrent indirect inguinal hernia. The topographical relationship of these two hernias suggested that an indirect inguinal hernia may cause an internal hernia in the medial inguinal fossa.

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“…Laparoscopic exploration has been increasingly employed for an internal hernia [ 6 , 7 ]. The present patient underwent laparoscopic surgery.…”

Section: Discussionmentioning

confidence: 99%

Internal hernia in the medial inguinal fossa with a concurrent indirect inguinal hernia: a case report

Shinohara

Hattori²,

Aono³

et al. 2023

Journal of Surgical Case Reports

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“…Internal SH was first reported by Ring in 1814, and it is an extremely rare condition, particularly in children. SH occurs in the triangular space surrounded laterally by the medial umbilical ligament, medially by the median umbilical ligament (urachus), and inferiorly by the transverse vesical fold, and it is classified as external or internal depending on the direction of sac extension [ 4 , 5 , 12 – 14 ]. External SH protrudes through the anterior abdominal wall, expanding into the inguinal canal and mimicking a direct inguinal hernia.…”

Section: Discussionmentioning

confidence: 99%

Neodymium magnets migrated into an internal supravesical hernia: a rare case of foreign body ingestion in children

et al. 2023

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Background Foreign body (FB) ingestion is a common event in children. The management of the ingested FB depends on the location, type, number, size of the FBs, patient age, and symptoms. Although most FBs pass spontaneously through the gastrointestinal tract without causing serious injuries, the ingestion of multiple high-powered magnetic pieces, especially neodymium magnets (NMs) increases the risks of morbidity and mortality. Supravesical hernia (SH) is rarely occurs in children, and few studies have reported SH in pediatric patients. We report an extremely rare case of ingested NMs that migrated into an internal SH in a pediatric patient. Case presentation A 3-year-old boy who had accidentally swallowed two NMs 3 days ago presented with vomiting and lower abdominal pain. X-ray imaging and computed tomography (CT) suspected the presence of a 1.0-cm radiopaque FB located in the terminal ileum dorsal side of the bladder. Although his abdominal pain was gradually getting better after oral feeding, repeat abdominal X-ray imaging showed that the FB was in a stagnant in position. Therefore, surgical intervention was planned to remove the FB 1 week after his admission. Under general anesthesia, laparoscopic and fluoroscopic examinations were performed and the cecum was found adhered to the retroperitoneum between the right medial umbilical fold and the right wall of the urinary bladder. The FB was presumed to be located at the tip of the incarcerated cecum in the retroperitoneal space. Peritoneum incision was started near the medial inguinal fossa, and the Retzius space was opened in a manner similar to the transabdominal pre-peritoneal approach for inguinal hernia repair. Consequently, the patient was diagnosed with internal SH with FB migration. The incarcerated cecum was pulled out, which revealed intestinal wall perforation. The FB remained in the retroperitoneal space in the pelvic cavity. The FB was easily removed using intestinal forceps and identified as combined two NMs. The postoperative course was good, and the patient was discharged on postoperative day 5. Conclusions We experienced an extremely rare case of a pediatric patient who swallowed multiple NMs that migrated into an internal SH, and the laparoscopic minimally invasive removal was successful.

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“…Typical C.T scan findings of a dilated bowel loop trapped in the Supravesical fossa compressing the bladder, as in this case, have been described in hope of improving accuracy in preoperative diagnosis. But the lack of awareness to this rare condition is a big obstacle in achieving this goal [14]. Patients are usually diagnosed with small bowel obstruction/ strangulation (47%) or internal hernias (17.6%), and undergo urgent surgery.…”

Section: Discussionmentioning

confidence: 99%

Internal Supra-Vesical hernia: A very rare cause of small bowel obstruction and review of literature

Hussain

2021

CRCCR

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A novel technique of laparoscopic reduction of incarcerated internal supravesical hernia via peritoneal incision: A case report

Cited by 3 publications

References 17 publications

Internal hernia in the medial inguinal fossa with a concurrent indirect inguinal hernia: a case report

Internal hernia in the medial inguinal fossa with a concurrent indirect inguinal hernia: a case report

Neodymium magnets migrated into an internal supravesical hernia: a rare case of foreign body ingestion in children

Internal Supra-Vesical hernia: A very rare cause of small bowel obstruction and review of literature

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