Transmesocolic Hernia Without a History of Digestive Surgery: Unknown Disease

Abstract

The incidence of internal hernia is less than 1%. Transmesocolic hernia (TH) is a rare type of internal hernia and it poses a real diagnostic challenge clinically. TH in patient without a history of operation hernia is an extremely rare phenomenon and is frequently none diagnosed. We report a case of TH in an adult patient without any preoperative history of digestive surgery. A 44-year-old woman was admitted to hospital for non-specific abdominal distension. The diagnosis of TH was suggested by computed tomography (CT). Entero-MRI confirmed the diagnostic. The symptoms were managed with conservative measures. The patient had no further pain during his follow-up and gave no recurrence. In the adult population, the cause of TH is previous gastrointestinal operation, intraperitoneal inflammation or trauma. Clinically, internal hernias can be asymptomatic, or can cause chronic dyspepsia, vague epigastric pain, intermittent colicky periumbilical pain, nausea and vomiting. There is extreme difficulty in making diagnosis of internal hernia preoperatively and the most important diagnostic method is abdominal CT and entero-MRI. This article illustrates the various types of internal hernias and imaging findings of TH. Even in cases with no previous laparotomy, it is important to consider the possibility of TH. We believe that conservative measures of TH are recommended in selected cases.




J Curr Surg. 2014;4(2):55-57
doi: http://dx.doi.org/10.14740/jcs227w