title: Incarcerated transmesosigmoid hernia presenting in a 60-year-old man: a case report.
abstract: BACKGROUND
  Internal hernias are a rare cause of small bowel obstruction and are estimated to account for 1% to 5% of cases. Herniation through a defect in the sigmoid mesocolon constitutes 6% of all internal hernias.
  
  
  METHODS
  In this case report we describe a rare case of a fit and healthy 60-year-old man, with no previous history of abdominal surgery, who presented with signs and symptoms of small bowel obstruction as a result of an incarcerated transmesosigmoid hernia. The hernia was reduced and the incarcerated loop of small bowel was found to be viable. The patient made a good recovery and was discharged home on the fourth post-operative day.
  
  
  CONCLUSIONS
  Internal hernias can cause considerable morbidity and mortality, so prompt diagnosis is paramount. Transmesosigmoid hernias are most common in the paediatric population; however, our patient was 60 years old. This report highlights the importance of considering an internal hernia as a cause of small bowel obstruction in individuals of all age groups and especially in those without a previous history of abdominal surgery.
authors.affiliation: Surgical Professorial Unit, St. Vincent's University Hospital, Ireland. daniellecollins@rcsi.ie
authors.forename: Danielle
authors.initials: D
authors.lastname: Collins
authors.forename: Dara
authors.initials: D
authors.lastname: Kavanagh
authors.forename: Eddie
authors.initials: E
authors.lastname: Myers
authors.forename: Steve
authors.initials: S
authors.lastname: Richards
authors.forename: Enda
authors.initials: E
authors.lastname: McDermott