Large congenital transmesenteric hernia: a missed small-bowel atresia?
Internal hernias are uncommon diagnoses and represent rare causes of intestinal obstruction. Diagnoses are frequently made perioperatively. We present herein an illustrated case of transmesenteric hernia diagnosed in a pregnant woman who consulted for severe abdominal and dorsal pains. As CT scan was not possible because of the obstetric history, a decision to perform surgery was made because of acute pain, no history of previous surgery, and a plain erect X-ray disclosing early signs of intestinal obstruction. Perioperative findings were an ileal volvulus through a transmesenteric fossa circled by a unique ileocolic branch. This particular vascular disposition suggests transmesenteric hernias may be the first step in the constitution of congenital small-bowel atresia.
Capito
C
C
Pediatric Surgery Department, CHU de Nantes, Hopital Mère-Enfants, 7 Quai Moncousu, 44093 Nantes, France. carmendoc@hotmail.com
Podevin
J
J
Lascarrou
J B
JB
Lehur
P A
PA
Armstrong
O
O
D000328:Adult; D005260:Female; D006555:Hernia, Ventral / Q000151:congenital*; D006801:Humans; D045822:Intestinal Volvulus / Q000151:congenital* / Q000000981:diagnostic imaging / Q000601:surgery; D007421:Intestine, Small / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D010535:Laparoscopy; D008643:Mesentery / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D011247:Pregnancy; D011859:Radiography