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Kumar N, Katragadda S, Mallik D, Dhamala I, Basu S. A rare case of abdominal cocoon associated with internal hernia in an adult. Niger J Clin Pract 2023; 26:128-131. [PMID: 36751835 DOI: 10.4103/njcp.njcp_426_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
A transmesenteric internal hernia (TIH) is a protrusion of a viscus through the mesenteric defect. It is secondary to previous gastrointestinal surgery in an adult. Early diagnosis and management are warranted to prevent the strangulation of the bowel in a TIH. Here, we are reporting a case of a 24-year-old gentleman with COVID-positive status who has presented with cough, abdominal cocoon, and features of subacute intestinal obstruction (SAIO) without any previous history of abdominal surgery. A nonoperative trial is given in the management of abdominal cocoon with SAIO. In contrast, delay in surgical intervention in TIH leads to bowel gangrene. Surprisingly even on contrast-enhanced computed tomography of the abdomen, TIH was not picked up. We have diagnosed this case intraoperatively with gangrene of the bowel. In an abdominal cocoon without any history suggestive of tuberculosis or previous surgery, or any other condition that leads to an intra-abdominal reaction, an internal hernia should be kept as a differential diagnosis. The delay in diagnosis and surgical intervention is associated with potentially disastrous complications.
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Affiliation(s)
- N Kumar
- Department of General Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - S Katragadda
- Department of General Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - D Mallik
- Department of General Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - I Dhamala
- Department of General Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - S Basu
- Department of General Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
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Wu YY, Liu PF. A case of congenital mesenteric hernia in the adult. Asian J Surg 2022; 46:1785-1786. [PMID: 36319546 DOI: 10.1016/j.asjsur.2022.10.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 10/13/2022] [Indexed: 11/18/2022] Open
Affiliation(s)
- Yun-Yun Wu
- Department of General Surgery, Suzhou Ninth People's Hospital, Suzhou Ninth Hospital Affiliated to Soochow University, SuZhou, China
| | - Peng-Fei Liu
- Department of Gastrointestinal Surgery, Suzhou Ninth People's Hospital, Suzhou Ninth Hospital Affiliated to Soochow University, SuZhou, China.
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3
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Beji H, Zaiem A, Atri S, Hammami M, Rebai W, Kacem M. Congenital transmesenteric hernia causing bowel strangulation. ANZ J Surg 2022; 92:2733-2734. [PMID: 35412024 DOI: 10.1111/ans.17716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 04/02/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Hazem Beji
- Department of General Surgery A, Hospital La Rabta, Tunis, Tunisia
| | - Asma Zaiem
- Department of General Surgery A, Hospital La Rabta, Tunis, Tunisia
| | - Souhaib Atri
- Department of General Surgery A, Hospital La Rabta, Tunis, Tunisia
| | - Mahdi Hammami
- Department of General Surgery A, Hospital La Rabta, Tunis, Tunisia
| | - Wael Rebai
- Department of General Surgery A, Hospital La Rabta, Tunis, Tunisia
| | - Montassar Kacem
- Department of General Surgery A, Hospital La Rabta, Tunis, Tunisia
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Transmesenteric hernia with closed-loop small bowel obstruction: A case report. Ann Med Surg (Lond) 2022; 74:103256. [PMID: 35106152 PMCID: PMC8784624 DOI: 10.1016/j.amsu.2022.103256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 01/06/2022] [Indexed: 11/22/2022] Open
Abstract
Background Transmesenteric hernia is a subtype of internal abdominal hernia (IAH) and a rare cause of small bowel obstruction in adults. Difficulty in reaching a definitive diagnosis due to non-specific clinical and imaging findings often cause life-threatening bowel ischemia. Case report We report a case of a 37-year-old female who presented with clinical and imaging features of small bowel obstruction. She underwent an emergency laparotomy where the diagnosis of transmesenteric hernia causing closed-loop obstruction was made. The non-viable portion of the intestine was resected, anastomosis of the ileum along with the closure of the mesenteric defect was performed. Discussion IAH is the protrusion of abdominal viscera, most commonly small bowel loops through a peritoneal or mesenteric defect into the abdominal or pelvic cavity. Considered common in children, it is rare in adults and is most common after abdominal surgeries like Roux-en-Y gastric bypass surgery. Clinical features and imaging findings are non-specific causing delay in the diagnosis. Conclusion A high index of suspicion is required while assessing the patient with symptoms suggestive of acute bowel obstruction as the preoperative diagnosis of a transmesenteric hernia is challenging. Transmesenteric hernia causing small bowel obstruction in the adult is rare. Diagnosis is often delayed due to non-specific clinical and imaging features. Careful exploration of the whole mesentery after reduction of hernia can prevent recurrences.
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Patel J, Hamedi A, Khalil M, El-Bahri J. Congenital Internal Hernia: Rare Cause of Acute Abdominal Pain. Case Rep Gastroenterol 2021; 15:791-794. [PMID: 34703421 PMCID: PMC8460935 DOI: 10.1159/000518293] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 07/01/2021] [Indexed: 12/17/2022] Open
Abstract
Acute abdominal pain is a common presenting symptom that possesses a wide differential. Congenital internal hernias are a rare condition that often presents with abdominal pain and can lead to obstruction. Early diagnosis is often difficult and therefore can present acutely and in an emergent setting. Prompt recognition of symptoms and evaluation are important to prevent poor prognosis. We are presenting a case of a congenital internal hernia in a patient presenting with nonspecific symptoms. Prompt diagnosis and subsequent surgical intervention allowed for appropriate management and resolution of symptoms.
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Affiliation(s)
- Jay Patel
- Department of Internal Medicine, Orange Park Medical Center, Orange Park, Florida, USA
| | - Antoine Hamedi
- Department of Internal Medicine, Orange Park Medical Center, Orange Park, Florida, USA
| | - Muhammad Khalil
- Department of Internal Medicine, Orange Park Medical Center, Orange Park, Florida, USA
| | - Jessica El-Bahri
- Department of Internal Medicine, Orange Park Medical Center, Orange Park, Florida, USA
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Turek B, Stefanik E, Kozłowska N, Drewnowska-Szczepakowska O, Górski K, Mickiewicz J. Malformation of a Mesocolon as a Cause of Colic in an Arabian Foal. Vet Sci 2021; 8:vetsci8090193. [PMID: 34564587 PMCID: PMC8472953 DOI: 10.3390/vetsci8090193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 08/31/2021] [Accepted: 09/10/2021] [Indexed: 11/22/2022] Open
Abstract
This paper describes a case of partial lack of the mesocolon in a 7-month-old colt. The foal was referred to the hospital with clinical signs of severe abdominal distension of a few hours duration. Because analgesics did not relieve pain, the foal remained uncomfortable, and distension of the abdomen increased; an exploratory laparotomy was performed under general anaesthesia in dorsal recumbency. The final diagnosis was confirmed intraoperatively. During exploration of the abdominal cavity, other problems like right dorsal displacement and torsion of the colon were recognized. Correction of all problems was completed, and the mesentery was sutured. Recovery from anaesthesia was uneventful. The foal was recovering well a few months after surgery, and the owner did not complain about the results of the treatment.
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Yuansheng X, Yi W, Jinyan F. Internal Hernia in Pregnant Woman due to Congenital Transmesenteric Defect. Pak J Med Sci 2021; 37:1540-1544. [PMID: 34475945 PMCID: PMC8377930 DOI: 10.12669/pjms.37.5.4116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Accepted: 05/29/2021] [Indexed: 11/15/2022] Open
Abstract
Congenital transmesenteric hernias are uncommon and are a rare cause of bowel obstruction, which is even rarer in pregnant woman. Because of the lack of specific symptoms or reliable sensitive markers, it is difficult to diagnose internal hernia at early stage, therefore resulting in the delay of surgical intervention and a high mortality rate, especially in pregnant woman. We report a case in which a woman presenting at 16 weeks` gestation was admitted with symptoms of nausea, vomiting and left upper abdominal pain similar to her first-trimester morning sickness. Nephrolithiasis of the left kidney detected by ultrasound may lead to early incorrect diagnosis. Due to the patient`s concern about known adverse effects of ionizing radiation on the fetus, computed tomography was postponed until abdominal pain worsened, coffee color gastric contents vomited and anus stopped exhaust and defecation 12 hours later. Low dose CT plain scan showed features of small bowel obstruction by an internal hernia. Emergency exploratory laparotomy revealed a mesenteric defect of the left colon with a 30 cm long jejunal herniating distal to 10 cm of the ligament of Treitz. The involved small bowel was strangulated and gangrened, necrotic segmental resection and end to end anastomosis were performed subsequently, and the mesenteric defect was then successfully repaired with sutures.
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Affiliation(s)
- Xu Yuansheng
- Xu Yuansheng, MD. Department of Emergency, Affiliated Hangzhou First People`s Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China
| | - Wang Yi
- Wang Yi, MD. Department of Emergency, Affiliated Hangzhou First People`s Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China
| | - Fang Jinyan
- Fang Jinyan, MD. Department of Emergency, Affiliated Hangzhou First People`s Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China
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Congenital transmesenteric internal hernia; A rare cause of bowel ischemia in adults: A case report. JOURNAL OF SURGERY AND MEDICINE 2019. [DOI: 10.28982/josam.543160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Al-Omari MA, Al-Doud MA. Simultaneous small and large bowel obstruction as a consequence of internal hernia: A case report. Int J Surg Case Rep 2019; 57:28-32. [PMID: 30877990 PMCID: PMC6423352 DOI: 10.1016/j.ijscr.2019.02.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 02/08/2019] [Accepted: 02/13/2019] [Indexed: 11/28/2022] Open
Abstract
There are no cardinal symptoms for internal hernia. Internal hernia must be kept as a differential diagnosis in the case of intestinal obstruction in both operated and non-operated abdomen. Early diagnosis both clinically and radiologically may prevent undesirable complications. Both patient status and surgeon's experience are essential to form the best surgical decision. Fine handling of bowel, assessment of viability, closure of defects and inspecting for other potential ones, and argumenting stoma formation are the main principles of surgery.
Introduction Intestinal obstruction ascribed to internal hernia is quite rare, especially in adults. There are no differentiating features in the presentation of intestinal obstruction due to internal hernia as compared to other causes. Delay in the diagnosis of this condition carries a considerable risk especially in a virgin abdomen. We report a rare case of internal hernia which presented as acute small and large bowel obstruction. Presented case We report a 47- year- old male with generalized abdominal pain associated with vomiting and obstipation. The patient was in hypovolemic shock that only had a transient response to resuscitation. CT scans of the abdomen with contrast was done and showed both large and small bowel obstruction. Exploration laparotomy was done and revealed a concurrent nonviable portion of ileum and twisted sigmoid colon (volvulus) which protruded through a congenital transmesentric defect. Resection was mandatory, and repair of the defect was done. Discussion Incidence of internal hernia generally does not exceed 1%. The diagnosis of congenital internal hernia relies on absence history of trauma, inflammatory process and abdominal surgery. Protrusion of simultaneous small and large bowels together through transmesenteric congenital gate is uncommon. Conclusion Whether the patient presenting with intestinal obstruction has a history of undergoing previous surgeries (for any reason) or not, the diagnosis of internal hernia must be kept in mind. Coexisting involvement of both small and large bowels that need resection poses the question of the need for restoration of bowel continuity with either colostomy or ileostomy.
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Affiliation(s)
- Malek A Al-Omari
- Department of General Surgery, Jordanian Royal Medical Services (JRMS), Amman, Jordan.
| | - Mohammad A Al-Doud
- Department of General Surgery, Jordanian Royal Medical Services (JRMS), Amman, Jordan.
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Yoshimaru K, Kinoshita Y, Matsuura T, Esumi G, Wada M, Takahashi Y, Yanagi Y, Hayashida M, Ieiri S, Taguchi T. Bowel obstruction without history of laparotomy: Clinical analysis of 70 patients. Pediatr Int 2016; 58:1205-1210. [PMID: 27061976 DOI: 10.1111/ped.13003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Revised: 03/04/2016] [Accepted: 04/01/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND Determining the cause of bowel obstruction without a history of laparotomy (BO without HL) is difficult and can result in delay of treatment and development of a potentially life-threatening situation. We herein investigated the clinical characteristics of pediatric patients who underwent laparotomy due to BO without HL. METHODS All surgical pediatric patients aged <16 age who were diagnosed with BO without HL between January 2004 and September 2014 were included. Etiology of BO, intraoperative findings and postoperative outcome were investigated retrospectively. RESULTS Seventy patients were diagnosed with BO without HL in this period. In these 70 patients, malrotation (n = 34), intussusception (n = 19), internal hernia (n = 6) and Meckel's diverticulum (n = 5) were predominantly identified. Regarding preoperative definitive diagnosis, prevalence of internal hernia, Meckel's diverticulum or idiopathic volvulus was significantly lower than that of malrotation or intussusception (P < 0.05). Intraoperatively, the rates of strangulation and bowel resection were 55.7% and 30.0%, respectively. The optimal time for emergency operation in order to avoid strangulated bowel resection was <19 h from onset of symptoms. CONCLUSIONS Malrotation and intussusception are major causes of BO without HL in children, but internal hernia, Meckel's diverticulum and idiopathic volvulus should always be taken into account, particularly because of the preoperative diagnostic difficulty and resulting high rate of intestinal resection. In order to avoid resection of the bowel, surgery should be done within 19 h before bowel ischemic change occurs.
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Affiliation(s)
- Koichiro Yoshimaru
- Department of Pediatric Surgery, Reproductive and Developmental Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoshiaki Kinoshita
- Department of Pediatric Surgery, Reproductive and Developmental Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Toshiharu Matsuura
- Department of Pediatric Surgery, Reproductive and Developmental Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Genshiro Esumi
- Department of Pediatric Surgery, Reproductive and Developmental Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Momoko Wada
- Department of Pediatric Surgery, Japan Community Health care Organization Kyushu Hospital, Kitakyushu, Japan
| | - Yoshiaki Takahashi
- Department of Pediatric Surgery, Reproductive and Developmental Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yusuke Yanagi
- Department of Pediatric Surgery, Reproductive and Developmental Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Makoto Hayashida
- Department of Pediatric Surgery, Miyazaki Prefectural Miyazaki Hospital, Miyazaki, Japan
| | - Satoshi Ieiri
- Department of Pediatric Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Tomoaki Taguchi
- Department of Pediatric Surgery, Reproductive and Developmental Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
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Mangal AK, Massey A, Patel P. Congenital transmesenteric hernia presenting with intestinal obstruction in an adult: a case report. ANZ J Surg 2016; 86:624-5. [PMID: 27459082 DOI: 10.1111/ans.13508] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2016] [Accepted: 02/02/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Akshay Kumar Mangal
- Division of Surgical Oncology, Department of Surgery, SMS Medical College and Hospital, Jaipur, India
| | - Aashish Massey
- Department of Surgery, SMS Medical College and Hospital, Jaipur, India
| | - Pinkain Patel
- Division of Surgical Oncology, Department of Surgery, SMS Medical College and Hospital, Jaipur, India
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Right sided transmesentric hernia: A rare cause of acute abdomen in adults. Int J Surg Case Rep 2014; 5:1154-7. [PMID: 25437662 PMCID: PMC4275791 DOI: 10.1016/j.ijscr.2014.11.037] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Revised: 11/11/2014] [Accepted: 11/12/2014] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION Transmesenteric mesocolic hernias are a rare cause of acute abdomen in adults with few reported cases in published literature. PRESENTATION OF CASE We report a rare case of a 30-year-old male with right-sided transmesenteric hernia of ileum due to a congenital mesocolic defect resulting in acute abdomen, presenting as acute abdomen. The hernia was reduced, small bowel inspected for gangrene and mesenteric hernia repaired, following which the patient made a good recovery and was discharged 5 days later. DISCUSSION The insidious onset of transmesenteric herniae and lack of specific radiological or laboratory investigations reaffirms the importance of surgeons maintaining a high index of suspicion for this surgical emergency. CONCLUSION Transmesentric hernia though rare can present as a case of acute abdomen in an emergency. The diagnosis is purely by a CT scan and close monitoring of the patient's general condition in cases of non-specific abdominal pain is essential to identify the rare deteriorating patient for early surgical intervention and optimal outcome.
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Edwards HM, Al-Tayar H. A transmesenteric congenital internal hernia presenting in an adult. J Surg Case Rep 2013; 2013:rjt099. [PMID: 24968431 PMCID: PMC3887995 DOI: 10.1093/jscr/rjt099] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Congenital internal hernias (CIAHs) are a rare cause of small bowel obstruction in adults. We present a case of transmesenteric CIAH in a 32-year-old male. The clinical examination and computed tomography scan were interpreted as intestinal obstruction, and only an emergency laparotomy revealed that 1 m of small bowel herniated through a 2 cm defect in the mesentery of the transverse colon. Repair of the defect was performed using interrupted suturing, and the patient was discharged after 4 days without sequelae.
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Affiliation(s)
- Hellen McK Edwards
- Department of Obstetrics and Gynecology, Herlev Hospital, Herlev, Denmark
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Abstract
Internal hernia is one of the rare causes of small bowel obstruction. A congenital mesenteric defect is very rare, but can potentially cause internal hernia with consequent incarceration or strangulation of the small intestine. An 18-year-old woman was brought to our emergency department with sudden onset lower abdominal pain. She had no remarkable past medical history and took no medications. An emergency laparotomy was performed. On exploring the abdominal cavity, the mesenteric defect was detected in the jejunal region, 3 cm in size. Loops of small intestine had gone through the defect three times in a complex manner and strangulated. Gangrenous intestine was resected and a primary anastomosis was performed. An adult congenital mesenteric defect is rare; however, it should be considered as one of the differential diagnoses in a relatively young patient with bowel obstruction without external hernia, previous abdominal surgery or trauma.
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Affiliation(s)
- Hideki Katagiri
- Department of Surgery, Tokyo Bay Urayasu Ichikawa Medical Center (Noguchi Hideyo Memorial International Hospital), Chiba, Japan
| | - Kenji Okumura
- Department of Surgery, Tokyo Bay Urayasu Ichikawa Medical Center (Noguchi Hideyo Memorial International Hospital), Chiba, Japan
| | - Junji Machi
- Department of Surgery, Tokyo Bay Urayasu Ichikawa Medical Center (Noguchi Hideyo Memorial International Hospital), Chiba, Japan Department of Surgery, University of Hawaii, Honolulu, Hawaii
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Butterworth J, Cross T, Butterworth W, Mousa P, Thomas S. Transmesenteric hernia: A rare cause of bowel ischaemia in adults. Int J Surg Case Rep 2013; 4:568-70. [PMID: 23685474 DOI: 10.1016/j.ijscr.2013.01.032] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2012] [Revised: 01/03/2013] [Accepted: 01/21/2013] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Transmesenteric herniae are a rare cause of bowel ischaemia in adults with few reported cases in published literature. PRESENTATION OF CASE We report a rare case of a 26-year-old female with spontaneous transmesenteric hernia of jejunum and proximal ileum due to a congenital mesenteric defect resulting in bowel gangrene, presenting initially with no haemodynamic or biochemical abnormalities. The hernia was reduced, small bowel resected and primary side to side anastomosis performed, following which the patient made a good recovery and was discharged 5 days later. DISCUSSION The insidious onset of transmesenteric herniae and lack of specific radiological or laboratory investigations reaffirms the importance of surgeons maintaining a high index of suspicion for this critical surgical emergency. CONCLUSION Close monitoring of the patient's general condition in cases of non-specific abdominal pain is essential to identify the rare deteriorating patient for early surgical intervention and optimal outcome.
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Affiliation(s)
- J Butterworth
- Cairns Base Hospital, Cairns, Queensland, 4870, Australia.
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Llore N, Tomita S. Apple peel deformity of the small bowel without atresia in a congenital mesenteric defect. J Pediatr Surg 2013; 48:e9-11. [PMID: 23331843 DOI: 10.1016/j.jpedsurg.2012.10.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2012] [Revised: 10/02/2012] [Accepted: 10/03/2012] [Indexed: 11/26/2022]
Abstract
Congenital mesenteric defects are rare causes of bowel obstruction. Even rarer are mesenteric defects with an apple peel type of deformity, probably described definitively only once previously. We present a case of a 3 year old boy who presented with a septic-like picture of severe metabolic acidosis and lethargy from a bowel obstruction with bowel ischemia. At laparotomy he was found to have bowel infarction due to herniation through a congenital mesenteric defect with an apple peel type of deformity of the bowel without bowel atresia.
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Affiliation(s)
- Nathaly Llore
- Division of Pediatric Surgery, Department of Surgery, New York University Langone Medical Center, New York, NY 10016, USA
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