A Case Report of Transmesosigmoid Hernia

Junichi Kaneko, Naoki Imai, Kenichiro Tateyama, Yasuhiro Sumi, Michiya Bando, Masaki Azuma, Naomasa Yoshida, Hideo Tohira, Yutaka Ozeki

Department of Surgery, Tosei National Hospital

A 53-year-old woman was treated conservatively under a diagnosis of ileus. However, abdominal pain, anemia and leukocytosis took a sudden turn for the worse until admission to our hospital. The abdominal distension, tenderness and rebound soreness over the entire abdomen were becoming worse. Plain X-ray and CT of the abdomen revealed a small-intestinal gas image and an air-fluid level. Under a diagnosis of strangulated ileus, an emergency operation was performed. Laparotomy revealed an oval defect 2.5 cm in diameter in the sigmoidmesocolon. About 150 cm of the small intestine was strangulated by the defect. The strangulated intestine was resected and the oval defect was closed. The post-operative course was uneventful and on the 14th post-operative day the patient was discharged. Transmesosigmoid hernia is very rare. The Japanese literature was reviewed.

Key words
transmesosigmoid hernia, internal hernia, defect of sigmoidmesocolon

Reprint requests
Junichi Kaneko Department of Surgery, Tosai National Hospital
762-1 Nagasawa, Shimizucho, Sunto-gun, Shizuoka, 411-8611 JAPAN

Accepted
July 22, 1998

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