Dealing with intramesosigmoid hernia: A rare variety of internal hernia

Shukla, Ankit; Bharti, Ramesh; Kumar, Satish; Chaudhary, Rajesh

doi:10.5455/aces.20151020060526

Cited by 2 publications

(5 citation statements)

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“…Despite the fact that an abdominal CT scan has a sensitivity and specificity of 63 and 73%, respectively, in diagnosing an internal hernia, internal hernias are frequently diagnosed intraoperatively in patients with acute intestinal obstruction during emergency laparotomies. The management of intramesosigmoid hernias includes reduction of the hernia and repair of the defect, which can either be accomplished laparoscopically or by an open approach 17 – 19 . Open approaches offer good ergonomics for the surgeons and mobility for the equipment, but laparoscopic procedures offer advantages of fewer complications and a shorter hospital stay 20 – 24 .…”

Section: Discussionmentioning

confidence: 99%

Sigmoid mesocolon internal hernia: a case report

Lukman¹,

Sulthana²,

Andreas³

et al. 2023

Annals of Medicine &Amp; Surgery

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Introduction and importance: Primary internal hernias are rare in adults. Internal hernias present clinically as a sign of small intestinal obstruction. If left untreated, internal hernias might lead to high morbidity and mortality due to strangulation. Internal hernias are usually diagnosed intraoperatively. Here, we present an internal hernia diagnosed with an abdominal computed tomography (CT) scan. The importance of preoperative diagnosis for internal hernias leads to early surgery and keeps the patient from suffering intestinal strangulation. Case presentation: We report here the case of a 67-year-old male who presented with acute intestinal obstruction and underwent an abdominal CT scan. The patient was diagnosed with an internal hernia from the imaging of the abdominal CT scan and scheduled for an exploratory laparotomy. An internal hernia was found in the mesocolon of the sigmoid colon; one loop of jejunum was trapped in the hernia defect. After reduction, the hernial defect was closed; no resections were done, and the patient was discharged after 5 days without complication. Clinical discussion: Our finding represents a transmesosigmoid hernia, a rare variant of sigmoid mesocolon hernias. The clinical sign and the judgment of the surgeon for the diagnosis of an internal hernia became important factors related to the patient’s outcome. Conclusion: The proper adjunct imaging, correct diagnosis, and timing of surgery for internal hernias save the patient from morbidity or intestinal death.

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Section: Discussionmentioning

confidence: 99%

Sigmoid mesocolon internal hernia: a case report

Lukman¹,

Sulthana²,

Andreas³

et al. 2023

Annals of Medicine &Amp; Surgery

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“…Intramesosigmoid hernias (IMSH) are the rarest of the three described. In 1964, Benson and Killen were the first to report this variety with barely more than 50 cases since described . They carry an associated bowel resection of 80% due to rapid progression of necrosis .…”

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confidence: 99%

“…The intersigmoidal types are the most common and involve herniation through the lateral aspect or to the left of the sigmoid mesentery into the intersigmoidal fossa. This occurs in the retroperitoneum where herniated bowel loops protrude into the congenital fossa (formed during fusion of lateral surface of the sigmoid mesocolon with the parental peritoneum of the abdominal wall) …”

mentioning

confidence: 99%

“…The transmesosigmoidal type describes herniation of bowel through an isolated oval defect in the mesosigmoid with involvement of both mesenteric leaves. Therefore, this type lacks a hernial sac …”

mentioning

confidence: 99%

“…However, the accuracy in diagnosing site and presence of strangulation is low. CT has a sensitivity and specificity of 63% and 73%, respectively, in diagnosing internal herniae . Detection is significantly poorer for mesosigmoid herniae and virtually impossible to establish subtype …”

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confidence: 99%

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