Transverse mesocolic hernia with intestinal obstruction as a rare cause of acute abdomen in adults: A case report

Abstract

BACKGROUND

Internal hernia is a rare cause of acute abdomen and intestinal obstruction in adults. Internal abdominal hernias include paraduodenal, perigastric, foramen of Winslow, intersigmoid, and post-anastomotic hernias and can be congenital or acquired. Internal hernias occur in 1%-2% of patients, and transmesocolic hernias are extremely rare. This report presents a patient with a transverse mesocolic hernia with a preoperative diagnosis of small intestinal obstruction.

CASE SUMMARY

A 45-year-old Chinese woman was admitted to the hospital with middle and upper abdominal pain for 2 d, abdominal distension, and vomiting. After abdominal computed tomography, she was diagnosed with an internal abdominal hernia complicated by small intestinal obstruction and underwent emergency laparoscopic surgery. The patient recovered well and was discharged 6 d postoperatively.

CONCLUSION

Transmesocolic hernias must be considered in adult patients with signs and symptoms of intestinal obstruction, even without a history of abdominal trauma or surgery.

Keywords: Internal hernia; Transmesocolic hernias; Abdominal computed tomography; Small bowel obstruction; Laparoscopic surgery; Case report

Core Tip: Transverse mesocolic hernia with intestinal obstruction is a rare cause of acute abdomen in adults. This case emphasizes the importance of considering a diagnosis of transmesocolic hernia in adult patients with intestinal obstruction, even in the absence of a history of abdominal trauma or surgery. Intraoperative images and video included with this case report highlight the surgical procedures required to treat these rare hernias.