Retrorectal herniation of the sigmoid colon

Abstract

A rare retrorectal hernia of the sigmoid colon associated with diverticulitis and a presacral abscess is reported. The anatomy of the retrorectal space is reviewed. The value of routine lateral fluoroscopy and overhead films is emphasized.

Retrorectal Hernia: A Rare Cause of Constipation Diagnosed on Magnetic Resonance (MR) Defecography

“…Retrorectal hernia is extremely uncommon, with limited reports of cases encountered in published scientific literature [ 1 , 6 ]. Retrorectal herniation is the pelvic floor protrusion of bowel loops through a defect in the peritoneum into the retrorectal space or other extraperitoneal spaces such as the Douglas’ and Retzius’ spaces [ 6 ].…”

“…Retrorectal herniation is the pelvic floor protrusion of bowel loops through a defect in the peritoneum into the retrorectal space or other extraperitoneal spaces such as the Douglas’ and Retzius’ spaces [ 6 ]. Retrorectal herniation of the sigmoid colon is the protrusion of a segment of the sigmoid colon into the presacral space and posterior to the rectum through a defect in the peritoneum [ 1 ].…”

“…Retrorectal hernias are a rare type of internal hernia, with only a few cases reported in the literature [ 1 , 2 ]. Retrorectal herniation of the sigmoid colon is the protrusion of a segment of the sigmoid colon through a defect in the peritoneum into the pre-sacral space and posterior to the rectum [ 1 , 3 ]. This peritoneal defect can be secondary to congenital mechanisms, surgery, trauma, or inflammatory processes [ 4 ].…”

Image of the Month—Diagnosis

“…6 There have also been reports of herniation of a sigmoid volvulus through transverse mesocolon, 7 transomental herniation mimicking sigmoid volvulus, 8 and retrorectal hernia of the sigmoid colon associated with diverticulitis. 9 Together, hernias, either internal or external, are a rare cause of LBO and are even less frequently coincident with sigmoid volvulus. This patient's extrinsic mechanical LBO was caused by both the incarcerated right inguinal hernia containing a redundant sigmoid colon, as well as volvulization of the same segment of colon.…”