Transverse Mesocolic Hernia in a Pregnant Woman with No Prior History of Laparotomy: A Case Report

Abstract

A 36-year-old pregnant woman with no previous history of laparotomy was admitted to our hospital for abdominal pain and vomiting in the 22nd week of pregnancy. Enhanced computed tomography revealed a closed loop with the beak sign in the right upper abdomen and a small amount of ascites. The patient was strongly suspected as having strangulated small bowel obstruction, and an emergency surgery was performed despite the pregnancy, since a cardiotocogram showed a reassuring fetal status. On laparotomy, a defect measuring approximately 25 mm in diameter was found in the mesentery of the transverse colon, and a part of the ileum (20 cm in length) was found to be incarcerated in this defect. The surgical diagnosis was transverse mesocolic hernia. The incarcerated segment of the ileum was reduced by traction. Since no ischemic injuries were observed in the ileum, no bowel resection was performed, and the defect in the transverse mesocolon was repaired by suturing. The postoperative courses of both the mother and fetus were uneventful, and the patient was discharged 15 days after the surgery.