Abstract
A 46-year-old female with abdominal pain and vomiting was admitted to our hospital with a diagnosis of bowel obstruction. She had not received abdominal surgery. Abdominal computed tomography showed small bowel loops dilated in the pelvic floor, which led to thin bowels. A long tube was inserted to the patient and conservative therapy was started. But no symptomatic remission was gained. On the 6th hospital day, enteroclysis performed through the long tube showed complete obstruction of the small bowel. We performed laparotomy on the 7th hospital day. The operative findings revealed a peritoneal defect in the pouch of Douglas, through which the ileum was incarcerated. The incarcerated ileum was reduced and then resected because it revealed impaired vascular perfusion. The peritoneal defect was closed by sutures. Her postoperative course was uneventful. The possibility of internal hernia should be kept in mind when examining the case of bowel obstruction offering no obvious reason even if conservative therapy can be employed.
