Early intervention in intersigmoid hernia may prevent bowel resection—A case report

Abstract

Intersigmoid hernia presents with acute obstruction, no past surgical history and no external hernia. Urgent CT scanning and early surgery may minimise strangulation, conserve bowel and reduce patient morbidity and mortality.

Strangulation of the small intestine caused by an intra-mesosigmoid hernia: a case report

“…Additionally, an internal hernia is a rare cause of small bowel obstruction in patients without a history of abdominal surgery or trauma with a reported incidence of up to 5.8% of small bowel obstruction [1–3]. However, if strangulated and left untreated, internal hernias demonstrate a mortality > 50% [4, 5]. In cases presenting as an emergency, preoperative diagnosis is very difficult due to rarity of this entity and limited utility of imaging in cases of acute intestinal obstruction [6].…”

Laparoscopic Repair of Incarcerated Intersigmoid Hernia

“…Indeed, previous attempts at nonoperative management of incarcerated intersigmoid hernias have been unsuccessful. 1,2 In these previously reported cases, laparotomy was eventually required and the length of stay was 8 days, compared with 36 hours after the laparoscopic repair in the present case.…”

“…2 It may occur as a depression or as a full peritoneal defect, 3 and it represents a localized failure of fusion along Toldt line between the visceral sigmoid peritoneum and the parietal peritoneum of the posterior abdominal wall. 4 Its prevalence at autopsy has been reported to be 65% 5 and so may be noted incidentally during abdominal surgery.…”

“…1 Internal hernias are the cause of small intestinal obstruction in less than 4% of cases. 2 The incidence is much higher, however, after gastric bypass surgery. 7 Sigmoid mesocolon hernias comprise only 5% of internal hernias and are a rare cause of small-bowel obstruction.…”

“…7 Sigmoid mesocolon hernias comprise only 5% of internal hernias and are a rare cause of small-bowel obstruction. 2 They are difficult to diagnose on clinical grounds, but suggestive CT findings include a U-or C-shaped cluster of small bowel posterior and lateral to the sigmoid colon. 5 There are no definitive features to differentiate the subtype of sigmoid mesocolon hernia on imaging.…”