A Case Report of Strangulated Bowel Obstruction due to an Internal Hernia In the Paracolic Gutter of the Descending Colon

Abstract

A 62-year-old man was admitted with sudden onset abdominal pain. A CT scan demonstrated incarcerated bowel loops lateral to and behind the descending colon. Strangulated bowel obstruction due to internal hernia was suspected based on the CT scan findings, and he underwent emergency laparoscopic surgery. Extensive adhesions were found between the descending colon and the left abdominal wall, and the small intestine had invaginated into the gap between the adhesive membrane and the paracolic region of the descending colon. A diagnosis of an internal hernia in the paracolic gutter of the descending colon was made. We opened the hernia orifice, and removed the strangulated intestine. We report herein on a very rare case of an internal hernia in the paracolic gutter of the descending colon.