Abstract
We report two cases of transmesenteric hernia of the ileum in adults. The first is a 21-year-old man who presented with upper abdominal pain, and no history of previous surgery. After one day of non-operative management, the abdominal pain persisted. A strangulated obstruction due to an internal hernia was suspected on a repeat computed tomography (CT) scan, and emergency operation was performed. A loop of the ileum, 80 cm in length, herniated through an ileal mesenteric defect 50 cm from the ileocecal junction. The herniated ileum was reduced and the mesenteric defect was closed with sutures. The second case is a 28-year-old woman who gradually developed abdominal pain and vomiting following cesarean section. A strangulated bowel obstruction was suspected by CT and emergency operation was performed on postoperative day 11. A loop of ileum 150 cm in length was herniated through a 4 cm ileal mesenteric defect located 100 cm from the ileocecal junction. A gangrenous section of ileum 150 cm in length was resected. Transmesenteric hernias are difficult to diagnose preoperatively. The findings obtained from repeat clinical and radiologic examinations over time are helpful in establishing the diagnosis. Surgical treatment should be considered early to avoid intestinal necrosis after performing a rapid evaluation.
