Abstract
An 81-year-old man with no previous history of surgery was referred to our hospital because of abdominal pain. There were tenderness and muscular guarding in the abdomen. Abdominal X-ray showed a dilated sigmoid colon and niveau signs. Abdominal computed tomography demonstrated a dilated sigmoid colon and the whirl sign of the sigmoid artery. Colonoscopy undertaken with a suspicion of sigmoid volvulus showed stenosis of the sigmoid colon and necrosis of mucous membrane. Therefore, an emergency surgery was performed with the diagnosis of sigmoid volvulus. Operative findings included a hernia orifice 8cm in diameter in the mesentery of the transverse colon and necrotic sigmoid colon invaginated through it. We performed repair of the hernia orifice and resection of the sigmoid colon, followed by ileostomy creation. Transmesocolonic hernia in the mesentery of the transverse colon is rare, and in this instance the hernia content is the small bowel in most cases and the transverse colon is rarely invaginated. We report a case of strangulation ileus of the sigmoid colon due to transmesocolonic hernia in the mesentery of the transverse colon.
