An Internal Hernia Caused by an Abnormal Hole Located in the Ascending Mesocolon

• Published in: Nippon Shokaki Geka Gakkai zasshi Vol. 46; no. 3; pp. 203 - 209
• Main Authors: Sato, Isao, Tabata, Tomotake, Mizutani, Makoto, Kumano, Kimituka, Okita, Atsushi, Fujimura, Masaki, Chino, Yoshihide, Shimoshiro, Reina, Masuda, Seiji, Iida, Minoru
• Format: Journal Article
• Language: Japanese
• Published: The Japanese Society of Gastroenterological Surgery 2013
• Subjects: colon; internal hernia; mesentery
• ISSN: 0386-9768; 1348-9372
• DOI: 10.5833/jjgs.2012.0178

A 46-year-old woman with abdominal pain was admitted to a local hospital and was given a diagnosis of ileus. However, as her condition did not improve after decompression with a long tube, and the cause of ileus was unclear, she was referred to our hospital on the 12th day after admission and underwent emergency surgery. Adhesion between the ascending colon and ileum made it difficult to diagnose and treat the cause of the obstruction using laparoscopy. We decided to switch to laparotomy, and performed an ileocecal resection combined with partial resection of the ileum adhered to the ascending colon. Macroscopic and pathological examination revealed that the ileum herniated into an abnormal hole located in the area of the mesenterium attached to the wall of the ascending colon, which therefore led to the diagnosis of an internal hernia. The postoperative course was uneventful and the patient was discharged on day 14 after the operation. Herein we report this rare case of an internal hernia where the small intestine herniated into an abnormal hole in the ascending mesocolon, together with comments on the literature.