A case of transmesosigmoid hernia

Abstract

A 48-year-old woman developed sudden lower abdominal pain at midnight, and was emergently conveyed to our hospital. An abdominal pain CT suggested ileus. She was thus admitted. The abdominal pain worsened. Therefore, contrast CT was repeated and ascites was recognized and also deteriorating dilatation of the small intestine loop. Because the small intestine loop was revealed in a limited area and malposition of the intestinal tract was doubtful, with the possibility of an internal hernia in mind, an emergency operation was conducted about 15 hours later under a diagnosis of strangulated ileus of the small intestines. Laparotomy revealed an abnormal defect approximately 2cm in diameter in the sigmoid mesocolon, through which the small intestine had herniated, and had been strangulated. Thus, ileus was diagnosed due to the transmesosigmoid hernia. Only closing the defect after repositioning the herniated intestine allowed the operation to be finished without intestinal resection. On the fifth post-operative day, the patient was discharged. Transmesosigmoid hernia is rare and the Japanese literature was thus reviewed.