Incarcerated transmesosigmoid hernia presenting in a 60-year-old man: a case report.
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.
Collins
Danielle
D
Surgical Professorial Unit, St. Vincent's University Hospital, Ireland. daniellecollins@rcsi.ie
Kavanagh
Dara
D
Myers
Eddie
E
Richards
Steve
S
McDermott
Enda
E