Internal Hernias due to Defects in the Meso-Appendix and Mesentery of Small Bowel, and Probable Ivemark Syndrome

Rooney, James A.; Carroll, James P.; Keeley, John L.

doi:10.1097/00000658-196302000-00011

Cited by 20 publications

(6 citation statements)

References 2 publications

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“…6 Most defects in the mesentery are 2e5 cm in diameter and typically congenital in origin and are located close to the ligament of Treitz or the ileocaecal valve. 7 Accurate preoperative diagnosis of an internal hernia is typically difficult because of the nonspecific preoperative clinical and laboratory data presented. The clinical picture of an internal hernia is that of mechanical small bowel obstruction with a presentation of severe periumbilical cramps, hyperactive bowel sounds, and progressive distention.…”

Section: Discussionmentioning

confidence: 99%

Transmesenteric hernia causing small bowel obstruction following lumbar microdiscectomy

Hsu

Lee

Yang

et al. 2015

Formosan Journal of Surgery

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KEYWORDS laparotomy; lumbar microdiscectomy; small bowel obstruction; transmesenteric hernia; Valsalva maneuver effect Summary A 54-year-old male patient underwent an L3e4 and L4e5 microdiscectomy. Two days after this operation, he suffered from acute abdominal pain accompanied by nausea and vomiting. A plain upright abdominal radiograph demonstrated multiple dilated small bowel loops with air-fluid levels.Abdominal computed tomography demonstrated diffuse dilatation of the small bowel loops with collapsed colon lumen. Laparoscopic laparotomy was performed after 4 days of conservative therapy without improvement. A 2e3 cm transmesenteric hernia, an uncommon type of internal hernia, and a short segment of entrapped jejunum were observed 40 cm from the ileocecal junction. The entrapped jejunum was viable and removed from the mesenteric defect without resection, and the defect was repaired; the patient recovered after laparoscopic repair. Small bowel obstruction caused by a congenital defect in the intestinal mesentery following microscopic discectomy has never been reported.

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Section: Discussionmentioning

confidence: 99%

Transmesenteric hernia causing small bowel obstruction following lumbar microdiscectomy

Hsu

Lee

Yang

et al. 2015

Formosan Journal of Surgery

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“…Transmesenteric hernias are more prone to develop volvulus and ischemia than other internal hernias due to the lack of a limiting hernia sac, which allows the herniation of a considerable length of small bowel. 17,[22][23][24][25][26][27] Eleven percent (n=3) with transmesenteric hernias had volvulized necrotic bowel.…”

Section: Discussionmentioning

confidence: 99%

Internal Hernias: Clinical Findings, Management, and Outcomes in 49 Nonbariatric Cases

Ghiassi

Nguyen

Divino

et al. 2007

Journal of Gastrointestinal Surgery

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Internal hernia, the protrusion of a viscus through a peritoneal or mesenteric aperture, is a rare cause of small bowel obstruction. We report the clinical presentation, surgical management, and outcomes of one of the largest series of nonbariatric internal hernias. Ten-year retrospective review of patients at our institution yielded 49 cases of internal hernias. Majority of patients presented with symptoms of acute (75%) or intermittent (22%) small bowel obstruction. While 16% of CT scans were suspicious for internal hernia, in no cases the preoperative diagnosis of internal hernia was made. The most frequent internal hernias were transmesenteric (57.0%) and 34 hernias (69%) were caused by previous surgery. All internal hernias were reduced and the defects were repaired. Compromised bowel was present in 22 cases and 11 patients underwent small bowel resection. The mean postoperative hospitalization was 10.9 days. The overall mortality rate from our series is 2%, and the morbidity rate is 12%. Transmesenteric hernias, as complications of previous surgeries, are the most prevalent internal hernias. Preoperative diagnosis of internal hernia is extremely difficult because of the nonspecific clinical presentation. However, if discovered promptly, internal hernias can be repaired with acceptable morbidity and mortality.

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“…Only one case each of a transmesenteric hernia through a defect in the mesentery of the appendix and through the mesentery of a Meckel diverticulum has been reported (33,34).…”

Section: Small Bowel Mesentery-related Herniamentioning

confidence: 99%

Internal Hernias in the Era of Multidetector CT: Correlation of Imaging and Surgical Findings

et al. 2016

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Clinical diagnosis of internal hernias is challenging because of their nonspecific signs and symptoms. Many types of internal hernias have been defined: paraduodenal, small bowel mesentery-related, greater omentum-related, lesser sac, transverse mesocolon-related, pericecal, sigmoid mesocolon-related, falciform ligament, pelvic internal, and Roux-en-Y anastomosis-related. An internal hernia is a surgical emergency that can develop into intestinal strangulation and ischemia. Accurate preoperative diagnosis is crucial for appropriate management. Multidetector computed tomography (CT), with its thin-section axial images, high-quality multiplanar reformations, and three-dimensional images, currently plays an essential role in preoperative diagnosis of internal hernias. The diagnostic approach to internal hernias at multidetector CT includes detecting an intestinal closed loop, identifying the hernia orifice, and analyzing abnormal displacement of surrounding structures and key vessels around the hernia orifice and hernia sac. At each step, multidetector CT can depict pathognomonic findings. A saclike appearance suggests an intestinal closed loop in several types of internal hernias. Convergence, engorgement, and twisting of mesenteric vessels in the hernia orifice can be seen clearly at multidetector CT, especially with use of multiplanar reformations. For definitive diagnosis of an internal hernia, analysis of displacement of anatomic landmarks around the hernia orifice is particularly important, and thin-section images provide the required information. Detailed knowledge of the anatomy, etiology, and imaging landmarks of the various hernia types is also necessary. Familiarity with the appearances of internal hernias at multidetector CT allows accurate and specific preoperative diagnosis. (©)RSNA, 2015.

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Internal Hernias due to Defects in the Meso-Appendix and Mesentery of Small Bowel, and Probable Ivemark Syndrome

Cited by 20 publications

References 2 publications

Transmesenteric hernia causing small bowel obstruction following lumbar microdiscectomy

Transmesenteric hernia causing small bowel obstruction following lumbar microdiscectomy

Internal Hernias: Clinical Findings, Management, and Outcomes in 49 Nonbariatric Cases

Internal Hernias in the Era of Multidetector CT: Correlation of Imaging and Surgical Findings

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