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Case Reports
. 2013 Oct-Dec;98(4):409-11.
doi: 10.9738/INTSURG-D-13-00114.1.

Small intestinal strangulation due to a rare type of primary internal hernia

Makoto Takeda  1 , Yoshinori Ohnuki, Takashi Uchiyama, Osamu Kubota, Kousuke Ohishi
Affiliations
Case Reports

Small intestinal strangulation due to a rare type of primary internal hernia

Makoto Takeda et al. Int Surg. 2013 Oct-Dec.

Abstract

Internal hernias in which the gate is located in the paracolic gutter are rare. A 75-year-old man was admitted to our hospital with severe epigastric pain without past history of laparotomy and/or trauma. He was diagnosed with strangulation of the ileum by the findings of computed tomography, and the operation was performed. During laparotomy, the small intestine was found to be strangulated and to enter the retroperitoneum from the right paracolic gutter near the hepatic flexure. The patient was diagnosed with an internal hernia, which differed from a pericecal hernia in that the hernia gate was located along the paracolic gutter near the hepatic flexure far from the cecum. Hence, it was considered to be a rare type of internal hernia. We report the clinical presentation and imaging findings of this rare internal hernia.

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Figures

Fig. 1
Fig. 1
(A) In an enhanced CT examination, it was found that a dilated region of the small intestine was gathered in the right upper abdomen, and weaker wall enhancement was also detected (horizontal image, arrow). (B) The undilated region of the small intestine extended into the dilated region (coronal image, arrowhead).
Fig. 2
Fig. 2
(A) Dilated ileum. (B) Transverse colon. (C) Stomach. The hernia sac, which contained the necrotic region of the small intestine and was located in the dorsal cavity of the mesentery of the transverse colon, was opened (arrow). The small intestine passed into the hernia sac (arrowhead). The hernia gate was located along the right paracolic gutter near the hepatic flexure.
Fig. 3
Fig. 3
Schema of the operation revealed the hernia gate was along right paracolic gutter near hepatic flexure.
See this image and copyright information in PMC

References

    1. Ghahremani GG. Internal abdominal hernias. Surg Clin North Am. 1984;64(2):393–406. - PubMed
    1. Rivkind AI, Shiloni E, Muggia-Sullam M. Paracecal hernia: a cause of internal obstruction. Dis Colon Rectum. 1986;29(11):752–754. - PubMed
    1. Ghahremani GG. Abdominal and pelvic hernias. In: Gore RM, Levine MS, editors. Textbook of Gastrointestinal Radiology. 2nd ed. Philadelphia, PA: Saunders; 2000. pp. 1993–2009. In. eds.
    1. Aggarwal BK, Rajan S, Aggarwal A, Gothi R, Sharma R, Tandon V. CT diagnosis of Meckel diverticulum in a paracolic internal hernia. Abdom Imaging. 2005;30(1):56–59. - PubMed
    1. Martin LC, Merkle EM, Thompson WM. Review of internal hernias: radiographic and clinical findings. AJR Am J Roentgenol. 2006;186(3):703–717. - PubMed

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