A Case of Inferior Ileocecal Hernia

• Published in: Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) Vol. 81; no. 4; pp. 778 - 782
• Main Authors: IWAKI, Takawa, UEKI, Kyo, ISHIZUKA, Dai, TADA, Takashi
• Format: Journal Article
• Language: Japanese
• Published: Japan Surgical Association 2020
• Subjects: inferior ileocecal recess; internal hernia; paracecal hernia
• ISSN: 1345-2843; 1882-5133
• DOI: 10.3919/jjsa.81.778

Here we report a case of the paracecal internal hernia into the inferior ileocecal recess. A 70-year-old woman with abdominal pain and nausea visited our hospital. Contrast-enhanced CT imaging revealed a ventrally-shifted cecum and a well-enhanced closed loop of the small intestine with mesentery in the dorsal space of the cecum. We diagnosed that she was suffering from a paracecal internal hernia and open surgery was performed. A 17 cm-long loop of incarcerated but viable ileum was found in the hernia orifice within the inferior ileocecal recess. We performed an appendectomy and opened the hernia orifice. There are four known types of recesses around the paracecal area : superior ileocecal recess, inferior ileocecal recess, retrocecal recess, and retro appendiceal recess. Meyer et al classified the paracecal hernia into four types : medial, lateral, retrocecal, and unclassifiable. The medial type of paracecal recess includes the superior ileocecal recess, inferior ileocecal recess, and retro appendiceal recess. While paracecal internal hernia of the retrocecal recess is frequently observed, the protrusion of this hernia into the inferior ileocecal recess is rare. To the best of our knowledge, this was the 6th case of paracecal internal hernia of the inferior ileocecal recess that was reported in Japan.