A case of intramesosigmoid hernia

Abstract

A 62-year-old woman was admitted in July 2008 because of sudden onset of abdominal pain, nausea, and vomiting. An abdominal X-ray examination and CT scan showed niveaus of the small bowel. A long tube was inserted, and conservative treatment was instituted on the second day after admission. However, a symptomatic remission was not achieved. Intestinal contrast study through a long tube showed obstruction of the small intestine. An operation was carried out on the thirteenth day after admission. The small intestine was incarcerated into a mesenteric defect of the right peritoneal surface of the sigmoid mesentery located 100 cm distal to the Treitz fascia. An internal hernia was diagnosed. The intussuscepted small intestine was released manually without performing intestinal resection, since no ischemia was present. The mesenteric defect of the right peritoneal surface was sutured. The postoperative course was uneventful, and the patient was discharged on the eighteenth day after surgery.