Congenital and acquired internal hernias: Unusual causes of small bowel obstruction

Newsom, Barry D.; Kukora, John S.

doi:10.1016/0002-9610(86)90258-8

Cited by 221 publications

(176 citation statements)

References 21 publications

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“…It usually presents as an acute SBO developing through normal or abnormal orifices 3 . The usual orifices through which herniation occurs are usually pre-existing anatomic structures such as foramens and fossa but they may also occur through pathological defects in the mesentery and visceral peritoneum which may be present congenitally, caused by surgery, trauma or through an inflammatory process 4 . Meyer has classified boundaries of internal hernias into six , including, paracecal sulci, caecal fossa, caecal recess, superior ileocaecal recess and retrocaecal recess 5 .…”

Section: Discussionmentioning

confidence: 99%

WITHDRAWN: An interesting case of retrocaecal internal herniation causing small bowel obstruction

Rae

Kalyanaraman

Ward

et al. 2015

Annals of Medicine and Surgery

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Section: Discussionmentioning

confidence: 99%

WITHDRAWN: An interesting case of retrocaecal internal herniation causing small bowel obstruction

Rae

Kalyanaraman

Ward

et al. 2015

Annals of Medicine and Surgery

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“…1 There are 2 broad categories of IH: acquired and congenital. These are further categorized by location, which include paraduodenal, transmesenteric, and supra-or perivesical IHs and those located at the Foramen of Winslow.…”

mentioning

confidence: 99%

Congenital Left Paraduodenal Hernia Causing Chronic Abdominal Pain and Abdominal Catastrophe

Shi¹,

Felsted²,

Masand³

et al. 2015

Pediatrics

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Paraduodenal hernias are the most common type of congenital internal hernia. Because of its overall rare incidence, this entity is often overlooked during initial assessment of the patient. Lack of specific diagnostic criteria also makes diagnosis exceedingly difficult, and the resulting diagnostic delays can lead to tragic outcomes for patients. Despite these perceived barriers to timely diagnosis, there may be specific radiographic findings that, when combined with the appropriate constellation of clinical symptoms, would aid in diagnosis. This patient first presented at 8 years of age with vague symptoms of postprandial emesis, chronic abdominal pain, nausea, and syncope. Over the span of 6 years he was evaluated 2 to 3 times a year with similar complaints, all of which quickly resolved spontaneously. He underwent multiple laboratory, imaging, and endoscopic studies, which were nondiagnostic. It was not until he developed signs of a high-grade obstruction and extremis that he was found to have a large left paraduodenal hernia that had volvulized around the superior mesenteric axis. This resulted in the loss of the entire superior mesenteric axis distribution of the small and large intestine and necrosis of the duodenum. In cases of chronic intermittent obstruction without clear etiology, careful attention and consideration should be given to the constellation of symptoms, imaging studies, and potential use of diagnostic laparoscopy. Increased vigilance by primary care and consulting physicians is necessary to detect this rare but readily correctable condition.Internal hernias (IHs) are a rare clinical entity that cause 0.6% to 5.8% of small bowel obstructions. 1 There are 2 broad categories of IH: acquired and congenital. These are further categorized by location, which include paraduodenal, transmesenteric, and supra-or perivesical IHs and those located at the Foramen of Winslow. 2,3 Paraduodenal hernias (PDHs) are thought to be the most common type of congenital IH. 2,3 However, with the increasing incidence of procedures that require Roux-en-Y reconstruction, such as gastric bypass surgery, Kasai, choledochal cyst excision, and pediatric liver transplantation, the incidence of acquired IH is increasing. 4 Left PDH refers to a herniation of the small bowel into a mesenteric defect to the left of the inferior mesenteric vein (IMV) with a hernia sac within the leaflets of the left colon mesentery. 5 Symptoms can range from intermittent partial bowel obstruction in cases of spontaneously reducing IH to acute high-grade obstruction that occurs with incarceration or volvulus. 6 Radiographic diagnosis is made difficult because of the often intermittent nature of the disease, in which spontaneous reduction in and resolution of symptoms can occur by the time diagnostic imaging is performed. 2,7 Even when present, Dr Shi drafted the initial manuscript; Ms Felsted assisted in drafting the initial manuscript; Dr Masand provided radiographic expertise, drafted the figure legends, and reviewed and revised the ma...

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“…Internal hernia is a characteristic condition of SBO, in which a loop of the small bowel herniates through a congenital or acquired peritoneal or mesenteric aperture within the abdominal cavity, resulting in strangulation of the herniated bowel [1,[7][8][9][10][11]. Internal hernia is an unusual cause of SBO, accounting for only 0.6-5.8% of total SBO cases [7].…”

Section: Discussionmentioning

confidence: 99%

“…Internal hernia is an unusual cause of SBO, accounting for only 0.6-5.8% of total SBO cases [7]. The types of internal hernia and frequency of each type are reported as follows: paraduodenal (53%), pericecal (13%), foramen of Winslow (8%), transmesenteric (8%), intersigmoid (6%), and transomental (1-4%) [1,8].…”

Section: Discussionmentioning

confidence: 99%

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Spontaneous Transomental Hernia Combined with Incarcerated Inguinal Hernia: A Case Report

Ohtsuka¹,

Takahara²

2017

J Gastrointest Dig Syst

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An 85-year-old woman was admitted to our hospital because of appetite loss and vomiting. She had no previous history of abdominal surgery, trauma, or intra-abdominal inflammation. Following the diagnosis of a small bowel obstruction due to an incarcerated left inguinal hernia, manual hernia repositioning was attempted, and proceeded smoothly. However, 42 hour after the procedure, she suddenly developed abdominal pain without recurrence of the incarcerated inguinal hernia. Abdominal computed tomography revealed signs of small bowel strangulation; therefore, emergency surgery was performed 48 hour after admission. On laparotomy, a defect was found in the greater omentum, and a part of the ileum was incarcerated by the defect. The operative diagnosis was spontaneous transomental hernia. Incision of the greater omentum was performed, and no ischemic changes were observed in the ileum; therefore, bowel resection was not performed, and the left inguinal hernia orifice was repaired. The postoperative course was uneventful. The transomental hernia in our case might have been induced because of the incarcerated inguinal hernia. For patients plagued with persistent small bowel obstruction after successful manual repositioning of an incarcerated inguinal hernia, concurrent internal hernia should be considered as a possible cause of the persistent small bowel obstruction.

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Congenital and acquired internal hernias: Unusual causes of small bowel obstruction

Cited by 221 publications

References 21 publications

WITHDRAWN: An interesting case of retrocaecal internal herniation causing small bowel obstruction

WITHDRAWN: An interesting case of retrocaecal internal herniation causing small bowel obstruction

Congenital Left Paraduodenal Hernia Causing Chronic Abdominal Pain and Abdominal Catastrophe

Spontaneous Transomental Hernia Combined with Incarcerated Inguinal Hernia: A Case Report

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