Abstract
Though the incidence of ileus due to internal hernia is not low, an internal hernia caused by the sigmoid colon epiploic appendix is extremely rare.
We report the clinical features of an internal hernia with a sigmoid colon epiploic appendix.
A 73-year-old woman was diagnosed as ileus from her clinical features. We performed an emergent operation under laparoscopic assisted surgery on the day after admission. Operative findings revealed that the epiploic appendix of the sigmoid colon formed a hernia orifice with the shape of a loop, and 40 cm of the small intestine was incarcerated into the hernia orifice.
Only 24 cases of ileus due to an internal hernia caused by the epiploic appendix were reported in Japan according to our investigation. The earlier operations showed patients had better results without resection of the small intestine. We need to keep this in mind for this disease when we face patients with ileus due to unknown origin and left lower abdominal pain. Early treatment is required to get a good prognosis.
