A Case of an Internal Hernia in the Left Paracolic Gutter Associated with Persistent Descending Mesocolon

Abstract

Persistent descending mesocolon (PDM) is a rare developmental anomaly resulting from insufficient fusion of the descending mesocolon with a posterior parietal peritoneum. A case of an internal hernia in the left paracolic gutter with PDM is presented. A 74-year-old woman was admitted to our hospital with vomiting and abdominal pain. Abdominal computed tomography showed small bowel obstruction and PDM as a mechanical cause of incarcerated herniation. Therefore, emergency surgery was performed. Laparotomy showed medial displacement of the descending colon and dilated small bowel without ischemic change. The lateral side of the left paracolic gutter had an orifice for herniation. Although the orifice and sac were opened, no fixation of the descending colon was added. Further investigation of PDM is needed to clarify whether it is necessary to perform surgical fixation of the descending mesocolon to the retroperitoneum.