A Case of Strangulated Ileus Caused by Intramesosigmoid Hernia with Left Paraduodenal Hernia

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  • 左傍十二指腸ヘルニアとS状結腸間膜内ヘルニアによる絞扼性腸閉塞の1例
  • 症例 左傍十二指腸ヘルニアとS状結腸間膜内ヘルニアによる絞扼性腸閉塞の1例
  • ショウレイ ヒダリ ボウ ジュウニシチョウ ヘルニア ト Sジョウ ケッチョウ カンマク ナイ ヘルニア ニ ヨル コウヤクセイ チョウ ヘイソク ノ 1レイ

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A 17-year-old girl visited our hospital because of sudden lower abdominal pain. An abdominal computed tomography scan showed dilation of the small intestine, bowel wall thickening, and the closed loop sign. We diagnosed strangulated ileus caused by an internal hernia and performed an emergency operation. A left paraduodenal hernia was observed. The hernia content filled almost the full length of the small intestine. Furthermore, a small defect in the right lobe of the sigmoid mesocolon was observed. A 30-cm loop of the ileum was herniated through the defect from the inside to the outside. The defect was slightly enlarged, and the herniated small intestine was successfully reduced. The 30-cm incarcerated small intestine appeared viable and was not resected. The two hernia orifices were repaired with running sutures. The patient had an uneventful postoperative course. She was discharged on postoperative day 7. This case of two internal hernias causing a strangulated ileus is rare.

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