傍結腸溝にかん入した盲腸周囲ヘルニアの１例

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  • AN UNUSUAL CASE OF PARACECAL HERNIA INCARCERATED INTO THE RIGHT PARACOLIC GUTTER

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We report an unusual case of paracecal hernia incarcerated into the retroperitoneal fossa along the right paracoloic gutter. An 82-year-old woman was referred to the hospital with abdominal pain and vomiting. Abdominal computed tomography showed a dilated small bowel situated right lateral to the cecum. Abdominal ultrasound revealed a low echoic tumor-like lesion suspected to be a dilated small bowel. A small bowel contrast examination showed a bowel obstruction in the right lower abdominal region. A laparotomy was carried out with a small incision. An abnormal orifice with a diameter of 1cm and an incarcerated loop of ileum were observed at the right side of the cecum. Reduction of the bowel loops was performed, and the orifice was simply closed without need for bowel resection. We highlight the importance of recognizing this untypical form of paracecal hernia as a cause of an internal hernia. Furthermore, we emphasize the need for preoperative diagnosis on the basis of significant radiological findings as well as the need to undergo minimally invasive treatment.

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