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INTERNAL HERNIAS INVOLVING THE SIGMOID MESOCOLON.

Annals of Surgery (Impact Factor: 7.19). 04/1964; 159:382-4. DOI: 10.1097/00000658-196403000-00008
Source: PubMed
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    ABSTRACT: Internal hernias are a rare cause of small bowel obstruction and are estimated to account for 1% to 5% of cases. Herniation through a defect in the sigmoid mesocolon constitutes 6% of all internal hernias. In this case report we describe a rare case of a fit and healthy 60-year-old man, with no previous history of abdominal surgery, who presented with signs and symptoms of small bowel obstruction as a result of an incarcerated transmesosigmoid hernia. The hernia was reduced and the incarcerated loop of small bowel was found to be viable. The patient made a good recovery and was discharged home on the fourth post-operative day. Internal hernias can cause considerable morbidity and mortality, so prompt diagnosis is paramount. Transmesosigmoid hernias are most common in the paediatric population; however, our patient was 60 years old. This report highlights the importance of considering an internal hernia as a cause of small bowel obstruction in individuals of all age groups and especially in those without a previous history of abdominal surgery.
    Journal of Medical Case Reports 02/2008; 2:161. DOI:10.1186/1752-1947-2-161
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    ABSTRACT: Computed tomography (CT) plays an important role in diagnosis of acute intestinal obstruction and planning of surgical treatment. Although internal hernias are uncommon, they may be included in the differential diagnosis in cases of intestinal obstruction, especially in the absence of a history of abdominal surgery or trauma. CT findings of internal hernias include evidence of small bowel obstruction (SBO); the most common manifestation of internal hernias is strangulating SBO, which occurs after closed-loop obstruction. Therefore, in patients suspected to have internal hernias, early surgical intervention may be indicated to reduce the high morbidity and mortality rates. In a study of 13 cases of internal hernias, nine different types of internal hernias were found and the surgical and radiologic findings were correlated. The following factors may be helpful in preoperative diagnosis of internal hernias with CT: (a) knowledge of the normal anatomy of the peritoneal cavity and the characteristic anatomic location of each type of internal hernia; (b) observation of a saclike mass or cluster of dilated small bowel loops at an abnormal anatomic location in the presence of SBO; and (c) observation of an engorged, stretched, and displaced mesenteric vascular pedicle and of converging vessels at the hernial orifice.
    Radiographics 07/2005; 25(4):997-1015. DOI:10.1148/rg.254045035 · 2.73 Impact Factor
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    ABSTRACT: We report a rare case of a sixty-year-old male who presented with an irreducible right inguinal hernia of 6-h duration, associated with vomiting and abdominal pain. Later in the course the hernia spontaneously reduced. After resuscitation and appropriate work-up, the patient was taken to operating room for a diagnostic laparoscopy. Consequent to finding hemorrhagic ascites and a loop of infracted bowel, a lower midline laparotomy was performed, which revealed a loop of intestine herniating through a tight defect in sigmoid mesocolon. Resection of the affected bowel with primary anastomosis was performed. Patient made an uneventful recovery and was discharged home on the 8th post-operative day. Patient was followed up at 2 and 4 weeks intervals in the surgical clinic and remained symptom-free.
    12/2013; 8(3). DOI:10.1016/j.jtumed.2013.03.005

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