A Rare Case of Internal Supravesical Hernia

Shinya Ohe, Shuichi Watabe, Yukio Inaba, Takashi Nomura, Akihiko Suzuki, Toshinobu Iinuma, Ken-ichi Hayashi, Masakazu Chiba

Department of Surgery, Yamagata Prefectural Kahoku Hospital

We report a rare case of internal supravesical hernia. The case was a 73-year-old male with no past history of abdominal surgery. He had been admitted three times because of intestinal obstruction that improved with conservative management. This time, he was admitted again because of intestinal obstruction with complaints of frequent vomiting and lower abdominal pain. As there was complete obstruction of the ileum on a small-intestine series, we diagnosed either invagination by an ileal tumor or internal hernia. Therefore, he underwent surgery for intestinal obstruction. We operatively established the diagnosis of intestinal obstruction due to incarceration of the ileum in a right internal supravesical hernia. Then, the patient received partial resection of the ischemic ileum and hernioplasty. In the classification of supravesical hernia that has a hernia orifice between the medial and lateral umbilical ligament, internal supravesical hernia in which the sac lies in the retropubic space of Retzius is very rare. Although there has been no case in which a final diagnosis was achieved preoperatively, in elderly cases with intestinal obstruction but no abdominal operation, we should consider the existence of supravesical hernia.

Key words
internal supravesical hernia, internal hernia, intestinal obstruction

Reprint requests
Shinya Ohe Department of Surgery, Yamagata Prefectural Kahoku Hospital
111 Gassando Yachi, Kahoku-cho, Yamagata 999-3511 JAPAN

Accepted
May 19, 1998

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