Transmesenteric hernia: a rare case of acute abdominal pain in children: a case report and review of the literature

Abstract

In this report, we discuss the case of an 11-year old girl presenting with acute abdominal pain caused by gangrene of a large part of the small bowel. During urgent surgical exploration, the cause of gangrene appeared to be herniation of the small bowel through a congenital defect in the mesentery with subsequent strangulation. A resection was performed leaving the patient with only 130 cm of small bowel remaining. Transmesenteric hernia is a rare type of internal herniation consisting of a small congenital defect in the small bowel mesentery through which the intestine can herniate and subsequently become strangulated. We present a case of transmesenteric hernia with disastrous effects and review the literature regarding this rare type of hernia.

Congenital Transmesenteric Hernia Without Bowel Strangulation in a Young Adult

“…The preoperative diagnosis of this congenital hernia is very difficult. The diagnosis is generally made at surgery (16). In our case, the preoperative clinical picture and laboratory data suggested acute appendicitis, not intestinal obstruction, and the accurate diagnosis was made during operation.…”

Internal hernia as cause of acute abdomen in a preterm neonate: when necrotizing enterocolitis is not the culprit

“…These emergencies are intestinal obstruction or intestinal perforation, and the causes are, predominantly NEC and spontaneous intestinal perforation (SIP). The differential diagnosis can also include intestinal atresia, meconium ileus, malrotation, Hirschsprung's disease, intussusception, or incarcerated hernia but they are not so common in this age group [ 1 , 2 ]. Internal hernia is a rare condition causing bowel obstruction and can occur at any age.…”

“…The majority of patients present with acute abdominal pain and distention, accompanied by bilious or non-bilious vomiting. Symptoms of shock can appear as the obstruction leads to bowel ischemia and gangrene [ 2 ]. Nevertheless, there are cases with vague and non-specific symptoms such as intermittent abdominal pain or vomiting that can be investigated for a long time before the diagnosis is confirmed [ 7 ].…”

Hérnia Transmesentérica – Uma Causa Rara De Dor Abdominal Em Adultos: Um Relato De Caso E Revisão Da Literatur

“…According to Willems et al (2018), failure to diagnose correctly or delaying surgical intervention inevitably results in bowel necrosis and, ultimately, mortality rates that have been documented to reach as high as 50%.…”