Abstract
An 85-year-old man with no previous history of laparotomy presented to our hospital with vomiting and abdominal tenderness. Physical examination revealed slight tenderness in the right lower quadrant of abdomen. Abdominal contrast-enhanced computed tomography showed a stricture of the small bowel around the cecum, and hence, he was admitted with the diagnosis of intestinal obstruction. Since neither conservative treatment nor an ileus tube relieved his symptoms, surgery was performed 13 days after admission with a diagnosis of an internal hernia. A peritoneal orifice with the diameter of 15 mm and an about 20-cm long incarcerated loop of ileum in the orifice were observed at the right side of the cecum. Reduction of the bowel loops was performed, and the orifice was closed without requiring bowel resection. The present case could not be classified according to the current Japanese classification of paracecal hernias, but it was classified into a lateral type paracecal hernia according to the Meyer's classification. It is important to be aware of this lateral type as one of paracecal hernias.
