Abstract
A 30-year-old woman was admitted to our hospital because of lower abdominal pain and vomiting. Abdominal plain X-ray film and abdominal CT scan revealed a small-intestinal gas image and an air-fluid level. There was an extended intestine like a loop, of which wall was poorly enhanced. An emergency operation was performed with a suspected diagnosis of strangulated ileus due to internal hernia. Laparotomy revealed an abnormal defect 1cm in diameter in the sigmoid mesocolon. Approximately 10cm portion of the small intestine, at a point 140cm proximal to the terminal ileum, had herniated through the defect and had been strangulated. The invaginated intestine was reduced by manupulation, when no necrosis was seen. The defect was repaired by sutures. The post-operative course was uneventful and the patient was discharged on the 10th post-operative day. Transmesosigmoid hernia in the mesentery of the sigmoid colon is very rare. This paper also present a review of the Japanese literature.
