Two cases of intramesosigmoid hernia performed laparoscopic treatment

Abstract

Two cases of internal ileus caused by intramesosigmoid hernia were laparoscopically treated during the last one year. Case 1 involved a 79-year-old man complaing of abdominal pain and poor appetite and case 2 involved an 80-year-old man complaining of left lower quadrant pain. A long tube was placed and after enough decompression of the small intestine, intestinal gastrograffin contrast study through it revealed obstruction of the small intestine in both cases. Internal hernia was thus diagnosed preoperatively and operations were carried out with laparoscopy on the third day in case 1 and on the 9th day in case 2 after admission. Operative findings showed an about 4 cm or about 3 cm defect in the left side of sigmoid mesocolon in the case 1 and case 2, respectively. The ileum was successfully freed from the hernia sac and the hernia orifice was sutured under laparoscopy in both cases. Their postoperative courses were favorable and they were discharged from the hospital on the 11th and 6th postoperative day, respectively.
Intramesosigmoid hernia is very rare. In this paper we present such two cases radically treated by laparoscopic procedure after decompression of the small intestine by the long tube, with a review of the literature.