Ｓ状結腸間膜内ヘルニアの１例

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  • A CASE OF INTERNAL HERNIA OF THE MESENTERY OF THE SIGMOID COLON

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A 61-year-old man who had the abrupt onset of abdominal pain during sleeping was diagnosed as having intestinal obstruction following abdominal plain x-ray examination at another institution and was admitted to the hospital for further exploration. There were no previous histories of laparotomy and trauma. Abdominal CT scan showed remarkable dilatation of the entire small intestine. Symptomatic remission was attained by placing a long tube, but no decrease in discharge was observed and ileus was not released. Even after long intestinal tube fluoroscopy, the origin of the disease was still unknown. Thus the patient was operated on with a suspicion of possible existence of obstructive lesion including a tumor on the 13th day after the onset of the disease. Laparotomy disclosed that the ileum about 30cm proximal to the terminal ileum was incarcerated through a 2-cm sized defect on serosa of the left lobe of mesentery of the sigmoid colon. Internal hernia of the mesentery of the sigmoid colon was diagnosed. The hernia was released, the defect was closed, and then the operation was finished without performing intestinal resection because of a slight degree of ischemia.<br> Internal hernia of the mesentery of the sigmoid colon has been reported in 27 cases, including our case, in the Japanese literature. Of these 27 cases, the defect in the left lobe is so rare to be reported in eight cases.

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