2025 Volume 74 Issue 4 Pages 201-204
Surpravesical hernia is a relatively rare condition that involves a hernial orifice in the supravesical fossa between the median and medial umbilical folds. This report describes a case of supravesical hernia that required bowel resection.
The patient was a 64-year-old male with a history of abdominal surgery at another hospital. He presented with chief complaints of abdominal pain and vomiting. Abdominal guarding was noted. An abdominal computed tomography（CT）scan revealed a pouch-like small bowel loop that was compressing the bladder. The patient was diagnosed with strangulated ileus due to an internal hernia, and an emergency ventral midline laparotomy was performed. Small bowel incarceration was identified at the left supravesical fossa. The hernial orifice measured 3 cm, and approximately 15 cm of small bowel was incarcerated. The necrotic segment of small bowel was resected, and the hernial orifice was closed using sutures.
Supravesical hernias have a low rate of pre-surgical diagnosis. Bladder compression by a small bowel loop is a characteristic CT finding. In cases of ileus of uncertain origin, the possibility of an internal supravesical hernia must be considered.
