Abstract
A 58-year-old woman without history of undergoing abdominal surgery presented to our hospital because of persisting lower abdominal pain and vomiting. An abdominal contrast-enhanced CT scan showed a small intestine forming a closed loop in the left lower abdomen. Internal hernia was thus suspected. Since the loop was short in distance and was located on the dorsal aspect of the sigmoid mesocolon and on the ventral aspect of the left common iliac artery, sigmoid mesocolon-related internal hernia, especially an intersigmoid hernia, was strongly suspected. CT scan showed no findings of bowel ischemia and there were few previous reports on that the incarcerated intestine became necrotic, so that elective laparoscopic surgery was performed after decompression by using a long tube. After retraction of the small intestine, the incarcerated bowel was reduced and the hernia orifice about 2 cm in diameter was closed by sutures.Furthermore, around the hernia orifice, an about 1 cm opening in the same morphology as the orifice was found. The hernia lumen was located between the mesentery of the descending colon and the parietal peritoneum, and so intersigmoid hernia was diagnosed.
As intersigmoid hernia rarely causes intestinal ischemia and the incarcerated bowel is short, the disease can be a good candidate for elective laparoscopic surgery following the tube decompression.
