Abstract
A 54-year-old man was admitted with abdominal pain and vomiting without a history of abdominal surgery or abdominal injury. Tenderness and mild rebound pain were recognized in the abdomen without muscular defense. Abdominal computed tomography revealed a dilated small bowel and suspected presence of internal hernia, but the symptom was so mild that conservative therapy with an ileus tube was performed. However, no symptomatic remission could be achieved. Intestinal contrast study through the ileus tube was conducted on the 4th day after admission. This study showed a loop-shaped small intestine in the left lower quadrant. A laparoscopic operation was carried out with a diagnosis of ileus due to internal hernia, especially mesosigmoid hernia. There was incarceration about 4 cm of the ileum into a mesenteric defect 3 cm in diameter on the left leaf of the sigmoid colon. The incarcerated small intestine was reduced, and the defect of the sigmoid mesocolon was closed by laparoscopic surgery. The postoperative course was uneventful, and the patient was discharged on the 12th day after surgery.
