Transverse Mesocolon Hernia into the Mesocolic Fossa Accompanied by Retrograde Jejunoduodenal Intussusception

Abstract

An 87-year-old woman with no history of abdominal surgery visited our hospital because of frequent vomiting. Since abdominal plain CT revealed gastric distension, the jejunum intussuscepted into the duodenum in a retrograde fashion and a mass was formed by the small intestine around the ligament of Treitz. An emergency laparotomy was performed for a suspected jejunal internal hernia accompanied by retrograde intussusception. Operative findings showed a 15-cm portion of the most proximal jejunum to be herniated and incarcerated in the transverse mesocolon through an orifice 2 cm in diameter formed at the mesocolic fossa. The invaginated intestine was reverted manually and had no necrosis. Intraoperative esophagogastroduodenoscopy revealed no neoplastic lesions, so the orifice was closed by suture. The postoperative course was uneventful. We report this rare case of transverse mesocolon hernia into the mesocolic fossa accompanied by retrograde intussusception.