Internal hernia with incarceration of the cecum through a loop created by an elongated fallopian tube

Forsythe, Charlie M.; Sanchirico, Paul J.; Pfeiffer, David C.

doi:10.1016/j.radcr.2018.11.010

Cited by 5 publications

(3 citation statements)

References 20 publications

(29 reference statements)

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“…There are several precipitating factors to forming a cecal volvulus, including recent abdominal surgeries, adhesions, and masses [4]. An essential prerequisite is the presence of a mobile cecum, which is estimated to occur congenitally in 10-25% of the population [5]. This condition typically arises when the normal peritoneal attachments fail to form due to disruption or over-rotation of the proximal colon during fetal development [4].…”

Section: Discussionmentioning

confidence: 99%

“…Another case reports a strangulated bowel caused by an internal herniation through a peritoneal defect between the right fallopian tube and ovarian vessels [2]. A third case describes an incarcerated mobile cecum resulting from an internal herniation through a loop created by an elongated left fallopian tube of 25 cm [5]. While the patient illustrated in this case presents similarly to our patient, our patient's right fallopian tube was 9.5 cm in length by 0.7 cm in diameter, which is closer to the average length of fallopian tubes seen in females in their 70s of 8.8 cm [7].…”

Section: Discussionmentioning

confidence: 99%

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Cecal Volvulus Through an Internal Hernia Created by an Elongated Fallopian Tube

Tran¹,

Song²,

Popovich³

2023

Cureus

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Internal hernias result from abdominal viscera protruding through a congenital or acquired defect in the peritoneum or the mesentery of the abdominal cavity. They are less common than external hernias, and the overall incidence is rare. Internal hernias carry a high mortality rate if there is no immediate surgical intervention and can lead to complications such as bowel perforation, ischemia, and necrosis. There are multiple classifications, and a rare subtype identified in only a select few cases involves the fallopian tube. This case documents the development of a cecal volvulus due to the cecum herniating through an aperture created by a normal-appearing fallopian tube attaching to the retroperitoneum.A 78-year-old female with multiple comorbidities was admitted for abdominal pain lasting 3-4 days, nausea, emesis, and poor oral tolerance. Computerized tomography imaging revealed a complete large bowel obstruction secondary to a cecal volvulus, and she was taken emergently for an exploratory laparotomy. Intra-operatively, a distended cecum was noted, herniated through a loop created by the right fallopian tube tethering its free end to the left pelvis. Upon decompression of the bowel, the fallopian tube released itself from the retroperitoneum. The cecum and right fallopian tube were noted to be ischemic and resected with an ileo-transverse anastomosis. Internal hernias that involve the fallopian tubes are a rare variation of an already uncommon condition. However, they should be included in the differential diagnosis when evaluating a female patient for intestinal obstruction since it can develop into a life-threatening condition that requires prompt surgical attention.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Cecal Volvulus Through an Internal Hernia Created by an Elongated Fallopian Tube

Tran¹,

Song²,

Popovich³

2023

Cureus

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“…These are rare occurrences, however, and examples of such cases reported in the literature are sparse. They include cases of incarceration of small bowel through a defect in the broad ligament [5], strangulated small bowel caused by an ectopic fallopian tube [6], and a case of incarcerated cecum due to an abnormally elongated fallopian tube where the distal end of the abnormal fallopian tube had become adherent to the parietal peritoneum in the left lower abdominal quadrant [7]. Our case reported here describes another mechanism of internal herniation, which has not been previously described in the literature to the best our knowledge, whereby a defect was created by an isolated fallopian tube torsion followed by necrosis and subsequent formation of an inflammatory adhesion to the adjacent sigmoid colon.…”

Section: Discussionmentioning

confidence: 99%

A unique case of small bowel obstruction secondary to internal herniation due to a torted fallopian tube adherent to the sigmoid colon

Choi¹,

Dharmawardhane²

2019

Int J Case Rep Images

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Introduction: Internal herniation is a rare cause of small bowel obstruction (SBO). An even less common in females, internal herniation can be secondary to abnormalities of the female reproductive organs in the pelvis. Case Report: A 76-year-old female patient presented with acute SBO which did not improve with initial conservative management. The patient was taken to the operating theatre for a laparoscopy revealing that the SBO was caused secondary to an internal herniation through a defect formed by a torted necrotic left fallopian tube adherent to the adjacent sigmoid colon. The patient was successfully treated with a laparoscopic left salingo-oophorectomy. Conclusion: Our case describes an unusual mechanism of internal herniation causing SBO in females. This case highlights the importance of considering a broad list of differential diagnoses in causes of SBO, as well as the importance of timely surgical intervention when indicated.

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A mesenteric defect causing internal herniation and ischaemia of both the ascending and sigmoid colons, treated with a bowel preserving surgery

et al. 2021

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Internal hernias due to mesenteric defects are a rare cause of bowel obstruction, but once present their complications are associated with a high morbidity and mortality. We present the case of a 24-year-old patient who presented to the emergency department with a 6-hour history of abdominal pain. Initial surgical review, taking into consideration the patient’s clinical, biochemical and radiological findings, led to the patient being taken for immediate surgical exploration. Operative findings included a very mobile caecum and proximal ascending colon which had herniated through a defect in the small bowel mesentery, the sigmoid colon had subsequently become incarcerated by the caecum and small bowel too. Both the ascending and sigmoid colon had become ischaemic. Due to the early decision for surgical intervention, we were able to consider a number of surgical strategies, and the surgery led to a positive outcome for our patient.

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Internal hernia with incarceration of the cecum through a loop created by an elongated fallopian tube

Cited by 5 publications

References 20 publications

Cecal Volvulus Through an Internal Hernia Created by an Elongated Fallopian Tube

Cecal Volvulus Through an Internal Hernia Created by an Elongated Fallopian Tube

A unique case of small bowel obstruction secondary to internal herniation due to a torted fallopian tube adherent to the sigmoid colon

A mesenteric defect causing internal herniation and ischaemia of both the ascending and sigmoid colons, treated with a bowel preserving surgery

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