A Case of Intersigmoid Hernia During Pregnancy

Abstract

A 35–year–old pregnant woman visited a hospital emergency department at 38 weeks of gestation because of epigastric pain. However, her symptom improved soon, and she was sent home. The following day, she visited the obstetrics and gynecology department at an institution in her neighborhood, but was urgently referred to the obstetrics and gynecology department of our institution. Examination at presentation led to the suspicion of small bowel obstruction, but abdominal computed tomography (CT) revealed no evidence of strangulation. Accordingly, a nasogastric tube was inserted, and the patient was hospitalized for conservative treatment. She then experienced labor pain and delivered a baby by normal vaginal delivery on the same day, but her abdominal symptom persisted. A repeat abdominal CT was performed the following day, which revealed strangulated bowel obstruction. An emergency surgery was therefore performed. The small intestine was found to be incarcerated and strangulated in the intersigmoid fossa. Small bowel resection was not performed, because the strangulated small bowel showed no evidence of ischemia. Subsequently, the hernial orifice was sutured and closed. The postoperative course was uneventful, and the patient was discharged on postoperative day 7. Intersigmoid hernia is a relatively rare disease, with only three cases, including the present case, reported during pregnancy to date. Herein, we report our experience with this case, along with a review of the literature on this topic.