A Case of Internal Hernia Involving the Sigmoid Mesocolon Diagnosed Preoperatively

Akira Igarashi, Koichi Okuda, Makoto Nishiwaki, Kazuyuki Tsujitsuka, Tokuhiko Kiyono, Masao Sumiyama

Department of Surgery, Hamamatsu Red Cross Hospital

A 60-year-old male was admitted with complaints of abdominal fullness and left lower abdominal pain. He had neither a past history of surgery nor injury. An abdominal X-ray showed niveau. The diagnosis of intestinal ileus was made. The patient showed no response to conservative therapy with an ileus-tube. Combined intestinal contrast study with enema using diatrizoate meglumine revealed occlusion of the ileum in the loop of the sigmoid colon. Abdominal CT showed the stenotic portion of the ileum in the sigmoid mesocolon. Diagnosis of internal hernias of the sigmoid mesocolon was made and an operation was carried out. There was incarceration of a part of the ileum in the right mesenteric round defect of the sigmoid colon, of which diameter was 7.5 cm. We easily reduced the incarcerated ileum manually and the hernia orifice was closed with sutures. The occurrence of internal hernia involving the sigmoid mesocolon is not common and only 22 cases have been reported in Japan. Among them, only 10 had intersigmoid hernia and ours is the first case diagnosed preoperatively.

Key words
intramesosigmoid hernia, ileus

Reprint requests
Akira Igarashi Department of Surgery, Hamamatsu Red Cross Hospital
1-5-30 Takabayashi, Hamamatsu, 430-0907 JAPAN

Accepted
February 12, 1998

To read the PDF file you will need Abobe Reader installed on your computer.