Small Bowel Obstruction Secondary to an Internal Hernia Through the Pouch of Douglas: A Case Report and Review of the Literature

... Internal hernias are a rare cause of SBO, contributing to only 0.6-5.8% of the cases, but with a mortality rate reaching 50% secondary to strangulation and ischemia [3,4]. They are classified according to the anatomical location where the defect occurs [5]. ...

... Upon reviewing the published literature on POD hernia on Pubmed, a few reported cases were found describing this unique entity of pelvic hernias. The age range of the reported cases was 17-80 years, a surgical history of hysterectomy was appreciated as the cause of hernia in the elderly patients, while a congenital etiology for the defect was the cause in the young patients with no previous surgeries [2,3] Our patient was young but had a previous laparoscopic left ovarian cystectomy, which explains the site of the defects seen intra-operatively. ...

... Nevertheless, its use is arguable, as no musculofacial defect is involved [1,2,7]. In two published cases, herniotomy and marsupialization were performed instead [3,9]. In our case, we performed reduction with primary closure. ...