Two Cases of Intestinal Obstruction Due to Internal Hernia

Akihiko Kobayashi, Hiroaki Koseki, Tsuyoshi Masuko and Yasuo Owada

Department of Surgery, Takahagi Kyodo Hospital

We experienced two cases of internal herniation through abnormal foramen of greater omentum and sigmoid mesocolon. A 44-year-old woman was admitted to the hospital for upper abdominal pain and vomiting. An intestinal obstruction due to internal hernia was diagnosed by radiocontrast study, and elective surgery was perfomed. Intra-operative findings disclosed two abnormal defects in the greater omentum and the lesser omentum, 2.0×2.0 cm in size. Approximately 20 cm of strangulated ileum was incarcerated, so resection was carried out and the foramen was closed. A 57-year-old man was admitted to the hospital for lower abdominal pain and vomiting. An intestinal obstruction due to internal hernia was diagnosed by radiocontrast study, and elective surgery was perfomed. Laparotomy revealed an intramesosigmoid hernia, containing 10 cm of non-ischemic small bowel. The hernia was reduced and the foramen was closed. Internal herniae account for about 1% of intestinal obstruction. However, in the absence of external herniae or previous surgery, the differential diagnosis of intestinal obstruction must include internal hernia.

Key words
intramesosigmoid hernia, transepiploic hernia, ileus

Reprint requests
Yasuo Owada Department of Surgery, Takahagi Kyodo Hospital 267 Arakawa, Takahagi-city, 318-0021 JAPAN

Accepted
January 26, 2000

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