A Case of Intramesosigmoid Hernia

Yoshifumi Sogo, Hidetoshi Fujiwara, Mitsuo Yamasaki, Taisuke Okamoto, Sohei Sakakua, Hiromasa Tomiyoshi and Harumasa Ohyanagi^*

Department Surgery, Wakakusa Daiichi Hospital Department Surgery II, Kinki University School of Medicine^*

Intramesosigmoid hernia is a rare type of internal hernia difficult to correctly diagnose preoperatively. A 65-year-old man admitted with nausea, vomiting, and lower abdominal pain had no history of surgery nor injury. Abdominal X-ray revealed air fluid levels. The patient underwent conservative therapy using a long-tube. Intestinal contrast sutdy through the long-tube showed obstruction of the small intestine at the lower abdomen. Abdominal computed tomography revealed obstruction of the small intestine. Surgery was undertaken the 11th day after symptom onset. Incarceration of the small intestine was seen 60 cm proximal from the terminal ileum into a mesenteric defect on the right side of the sigmoid colon, and the proximal small intestine was dilated. The incarcerated ileum reverted easily by manipulation and the hernia orifice, 3.0 cm in deameter, was closed with sutures. The postoperative course was uneventful and the man discharged on postoperative day 14. The occurrence of intenal hernia involving the sigmoid mesocolon is rare, with only 15 cases, including ours, involving intramesosigmoid hernia reported in Japan.

Key words
Intramesosigmoid hernia, internal hernia, ileus

Reprint requests
Hidetoshi Fujiwara Department Surgery, Wakakusa Daiichi Hospital 1-6 Wakakusacho, Higashiosaka, 579-8056 JAPAN

Accepted
April 25, 2001

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