Difficulty in Diagnosis of a Case of Intramesenteric Hernia in Children: A Case Report

Abstract

An 11-year-old boy with a complaint of two days of vomiting and abdominal pain was transferred to our hospital for small bowel obstruction (SBO). His CT images obtained from a previous hospital showed SBO caused by an intestinal malrotation with internal hernia. Emergency laparotomy was performed. On the basis of the intraoperative findings, he was finally diagnosed as having an intestinal malrotation and intramesenteric hernia (Treves’ field hernia). The hernia sac and its orifice was located at the ventral part of the superior mesenteric vessels. Right paraduodenal hernia is the most common type of internal hernia associated with intestinal malrotation and shows findings similar to those of intramesenteric hernia in diagnostic imaging. Intramesenteric hernia should be discriminated from paraduodenal hernia by careful intraoperative confirmation.