[Neonatal intestinal obstruction due to transmesenteric hernia with jejunoileal atresia: an unusual etiology]

Abstract

Transmesenteric hernia is an internal hernia without a sac caused by a congenital defect of the mesentery. It is a rare cause of intestinal atresia, usually diagnosed intraoperatively, therefore, its prognosis is variable and may be associated with high morbidity and mortality.

Objective: To report a case of transmesenteric hernia with multiple intestinal atresia of late diagnosis.

Clinical case: Male newborn, born at term, referred due to vomiting, scanty bowel movements, and abdominal distention. At 8 days of age and after excluding various causes of abdominal distention, the patient underwent exploratory laparotomy, identifying a transmesenteric hernia and two sites of intestinal atresia. Resection of the atretic segment and primary anastomosis were performed, with good evolution.

Conclusions: In the presence of neonatal intestinal obstruction, an appropriate differential diagnosis should be made, excluding the most frequent causes of intestinal obstruction, without leaving aside those unusual but potentially serious conditions, such as transmesenteric hernia associated or not with intestinal atresia.