A CASE OF MESENTERIC HIATAL HERNIA OF THE ASCENDING MESOCOLON

Abstract

Mesenteric hiatal hernia, an internal hernia, is a relatively rare herniation of bowel through an unusual hiatus in the mesentery. We report a unique case of hiatal hernia of the ascending mesocolon. A 91-year-old female consulted a nearby hospital complaining of subumbilical pain. A diagnosis of ileus was made, and she was referred to our hospital. When the symptom was not alleviated by conservative treatment with a long tube, surgery was performed 12 days after the onset of symptoms. Laparotomy revealed an unusual hiatus (about 4cm in size) in the ascending mesocolon, which was incompletely attached to the retroperitoneum. A protrusion of small intestine (about 70cm through the hiatus into the dorsal side) was located about 100cm distal to the ligament of Treitz. No impairment of blood flow to the bowel was noted. The patient's postoperative course following repair of the herniation and closure of the hiatus was good, and she was discharged from the hospital 21 days after the operation.