Large congenital mesenteric defect presenting in an adult (original) (raw)
Related papers
Small Bowel Obstruction Caused by Internal Herniation Through a Mesenteric Defect—a Case Report
Indian Journal of Surgery, 2018
Small bowel obstruction due to internal herniation is a rare entity specially when there is no history of previous surgery. Here, we have described a 14-year female without any previous surgical history admitted with features of small bowel obstruction. Without improvement of symptom by conservative management, an operation was performed. During surgery, it was observed that distal ileum was herniated through a mesenteric defect of small bowel itself. Because of this herniation, there was a segment of gangrenous ileum which was resected, and anastomosis was performed. Later, patient was discharged without any complication.
Congenital mesenteric defect — A rare cause of internal herniation in adults
Hellenic Journal of Surgery, 2014
Background: Mesenteric defect, congenital or acquired, is a rare cause of internal hernia. Most documented cases of internal hernias caused by congenital mesenteric defects are described in the paediatric population; its incidence is very rare in adults. Case report: We present the case of a previously asymptomatic 65-year-old man with a defect involving the mesentery of the terminal ileum. Almost the entire ileum had herniated through it twice in a complex manner and had become strangulated. The residual mesenteric defect was closed after relieving the obstruction, resecting the gangrenous part of ileum, and performing an end-to-side ileotransverse anastomosis. Results: The recovery was uneventful and the patient was discharged on the eleventh postoperative day. Conclusion: Reports of strangulated congenital mesenteric hernia at this age are scarce. Severe unexplained abdominal pain in adults with a virgin abdomen can be due to mesenteric hernia. A high index of suspicion and early surgical intervention can prevent a potential catastrophe.
Congenital mesenteric defects in an adult: A case report
South Sudan Medical Journal
A congenital mesenteric defect in an adult is very rare, but can cause an internal hernia with small bowel obstruction. Awareness of congenital mesenteric defects is important to the general surgeon when faced with an acute abdominal condition. We report a case of a congenital mesenteric defect in a 40-year-old man who presented to the emergency department with acute abdominal pain. An X-ray revealed multiple air fluid levels with dilatation of small and large bowels suggestive of bowel obstruction or bowel ischaemia, or bowel perforations. He underwent an emergency laparotomy through a midline incision. A large mesenteric defect was discovered with viable small and large bowel. A primary repair of the defect was carried out. The patient had an uneventful recovery. Early diagnosis and treatment are essential to avoid bowel ischaemia and decrease the mortality and morbidity.
Congenital middle mesocolic hernia – An unusual cause of small bowel obstruction
Hellenic Journal of Surgery, 2017
Internal herniation is a rare cause of small bowel obstruction, with an incidence of 0.2-0.9%. Obstruction due to congenital internal hernias is even rarer. The commonest type of congenital internal hernia is the paraduodenal or the mesocolic hernia. The left and right mesocolic hernias constitute 75% and 25% of the mesocolic hernias respectively. Middle mesocolic hernias are an extremely rare and unusual variant of mesocolic hernia, and literature search revealed only three reported cases. In view of its rarity, a high level of clinical suspicion, supported by radiological evidence is required to diagnose it preoperatively. Prompt surgical management is mandatory to reduce complications and their associated morbidity and mortality.
Transmesenteric Hernia Causing Intestinal Obstruction in Adult Male : A Rare Case Report
2018
Internal hernia is a rare cause of small bowel obstruction. A 45 year old male presented with acute intestinal obstruction for 2 days. On exploratory laparotomy, a mesenteric defect of 7*8 cm was present 90 cm distal to duodenojejunal junction with small bowel herniating through that defect. The part of bowel herniating was gangrenous. Resection of the gangrenous segment was done and end to side anastomosis between jejunum and transverse colon was done. Post-operatively the patient remained stable and was discharged under all satisfactory conditions. Internal hernia is one of the rare causes of small bowel obstruction. It is reported that 0.2–0.9% of patients of small bowel obstruction have internal hernia. A high index of suspicion for congenital mesenteric defects is warranted in patients who present with features of intestinal obstruction in the absence of obvious external hernia or previous abdominal surgery.
International journal of surgery science, 2023
Introduction: In children, internal herniation with small bowel strangulation due to the cause of a mesenteric defect is a rare cause of intestinal obstruction. So early diagnosis and early treatment in the paediatric emergency department are important factor for this disease. Aim: This case report, aim is to study the small bowel volvulus with large mesenteric defect in paediatrics patient, which is very rare. Method and materials: A male child of 2 year and 8-month-old came to the emergency department of our institute with complains of abdominal pain, vomiting (bilious) and not passing stool for 2 days. On radiographic findings shows that, internal herniation is gaseous distension of the bowel loops in the upper abdominal area with a paucity of gas in the lower abdomen. Primarily patient vitally stabilized and plan for emergency operation. Exploratory laparotomy done and large mesenteric defect closed. Gangrenous segment resected and end ileostomy done with distal mucous fistula formation. Patient discharged successfully on 6 th pod. Conclusion: Early diagnosis and treatment is very important in these patients. The most important step for this disease is early diagnosis of acute intestinal obstruction sign and symptoms like-tenderness, guarding and rigidity also vomiting and painful abdomen. So, it is very important that, Internal herniation should be considered in differential diagnoses of acute abdomen in the Paediatric Emergency Department.
American Journal of Case Reports, 2021
Internal hernias involve protrusion of the small bowel through a peritoneal or mesenteric space in the abdominal or pelvic cavity. Congenital internal small bowel hernias are rare and patients with them usually present with small bowel obstruction (SBO) at a young age, whereas in older patients, internal small bowel hernias usually are acquired secondary to previous surgery. The present report is of a rare case of SBO due to dual congenital internal small bowel hernias in a 51-year-old man with no history of abdominal surgery. Case Report: We report a case of dual congenital internal hernias of the small bowel in a patient who presented with symptoms and signs of SBO. He had no history of abdominal trauma, surgery, or comorbid conditions. His abdomen was mildly distended with minimal tenderness in the upper left quadrant but there was no guarding or rebound tenderness. Abdominal X-rays confirmed the SBO. A contrast-enhanced computed tomography scan of the patient's abdomen revealed SBO with transition at 2 points, suggestive of a closed-loop obstruction. However, the exact cause of the SBO was confirmed at laparotomy, which revealed dual internal hernias (intramesosigmoid and paraduodenal). The hernias were managed individually and the patient had a successful outcome after surgery. Conclusions: Although the present report is of a rare presentation of internal small bowel hernia, the case underscores that patients with this condition may present with SBO. Successful surgical management requires knowledge of the intra-abdominal peritoneal spaces and management of the hernia sac.
Congenital transmesenteric defect causing bowel strangulation in an adult
Hernia, 2009
Introduction Congenital transmesenteric hernias represent a very small group of internal hernias which are uncommon and are a rare cause of intestinal obstruction. Diagnosis is frequently made at surgery. Reports of congenital transmesenteric hernia in the English literature usually involve the pediatric population; adult cases are rarer. Case report A 22-year-old man who presented with a day's history of severe abdominal pain but without classic physical examination signs of abdominal obstruction was operated upon on account of increasing abdominal pain and distention associated with shock. Laparotomy revealed a congenital transmesenteric defect through which loops of bowel had herniated and become gangrenous, resulting in resection and end-to-end anastomosis. Discussion Congenital transmesenteric defects causing internal hernias in adults are rare. Preoperative diagnosis of the condition is difficult, in part, because there are no radiographic or laboratory findings to confirm the suspicion. Misdiagnosis resulting in delayed exploration may lead to small bowel necrosis and subsequent mortality. Conclusion A congenital internal hernia should be considered in a patient with bowel obstruction without previous abdominal surgery, inflammatory abdominal condition, or trauma. We wish to emphasize that, rather than trying to establish a correct diagnosis, the patient's clinical features should lead to early surgery in order to reduce morbidity and possible mortality.
Internal Hernia as a Cause of Acute Abdomen in a Pediatric Patient
Cureus, 2021
An acute abdomen is a complex case with multiple possible etiologies and requires the help of many different disciplines. We present the case of a two-year-old female who presented to the emergency department in acute distress, pale in complexion, and continuously guarding her abdomen. Physical examination revealed a distended, rigid abdomen with tenderness to palpation of the abdomen in all four quadrants. A computed tomography scan illustrated markedly dilated loops of small bowel but unclear etiology of obstruction with no evidence of perforation. Stat diagnostic laparotomy showed a strangulated internal hernia secondary to a congenital mesenteric defect. The mesenteric defect was repaired laparoscopically, and 25 cm of necrotic bowel was resected with an end-to-end anastomosis. Internal hernias secondary to mesenteric defects are the most common forms of internal hernias in pediatric patients and present with a 100% mortality rate if left untreated. This case illustrates the imp...