2018 Volume 43 Issue 5 Pages 964-970
A woman in her 70s with no prior history of surgery was admitted to our hospital with a history of recurrent abdominal pain and vomiting. She was diagnosed as having internal hernia. Conservative therapy was started, but her symptoms did not improve. Abdominal CT and gastrografin contrast examination revealed prolapse of the small intestine behind the stomach. These findings suggested a paraduodenal hernia or a transmesocolic hernia, therefore, laparoscopic surgery was performed. Intraoperatively, it was confirmed that the small intestine had prolapsed into the mesentery of the transverse colon in the anterior aspect of the Treitz ligament. Therefore, we made the diagnosis of transmesocolic hernia in the mesentery of the transverse colon. In Japan, 33 cases, including our present case of transmesocolic hernia, have been reported, however, only six underwent laparoscopic repair. The intraoperative blood loss and the postoperative hospital stay were significantly shorter in the cases that underwent laparoscopic surgery than in those that underwent open surgery. Therefore, it is suggested that laparoscopic surgery is a good approach for the diagnosis and treatment of transmesocolic hernia.
