A Case of Transmesosigmoid Hernia with Prolapse of an Elongated Sigmoid Colon

Abstract

The patient was a 60-year-old man with a history of surgery for appendicitis. He visited the emergency department of our hospital with complaints of vomiting and cessation of defecation. Contrast-enhanced computed tomography showed a closed loop in part of the sigmoid colon, and strangulated bowel obstruction of the sigmoid colon caused by an internal hernia was diagnosed. Emergency surgery was performed with a preoperative diagnosis of transepiploic hernia.

Intraoperative findings showed that the elongated sigmoid colon was prolapsed to the sigmoid mesenteric hiatus. No intestinal ischemia was observed, and no bowel resection was needed. Internal hernias in the sigmoid mesenteric hiatus are relatively rare. All previous reports indicated that prolapsed organs were small intestines, but in this case, a prolapse of the sigmoid colon to the sigmoid mesenteric hiatus was found, and this condition of internal hernia is very rare.