A CASE OF INTERNAL SUPRAVESICAL HERNIA

Abstract

An 86-year-old woman was admitted to the hospital because of vomiting and abdominal pain. She had been found having obturator hernia by abdominal CT scan while she had been hospitalized in another hospital for pneumonia. Examinations on admission disclosed no inflammatory findings, so that a long tube was placed and her clinical course was observed. However, no symptomatic remission was attained and she was indicated surgery. Upon laparotomy, the ileum (70cm up to the Bauhin's valve) was incarcerated into the left supravesical fossa with a type of Richter's hernia. We performed partial resection of the ileum and the fossa was closed with a few stitches.
Pelvic hernia in supravesical fossa is so rare that only 15 cases, including our case, have been reported in Japan. There have been no cases in which the correct diagnosis was made before surgery. The disease shows very similar symptoms and imaging findings to those of other hernia in the inguinal region, or it is often associated with them. Internal supravesical hernia is considered to be an important disorder for elderly people, though it is not so common for them. We present this case, because it is rare in that an elective surgery could be done for absence of necrosis despite the prolonged incarceration.