title: Large congenital mesenteric defect presenting in an adult.
abstract: Congenital internal hernia is a rare cause of bowel obstruction in adults and often presents with complications. A high index of suspicion, occasionally aided by appropriate radiological imaging, should lead to early surgical intervention and thus reduce morbidity and mortality. We describe a case of a 27-year-old woman who presented with upper abdominal pain and nonspecific abdominal signs. Computed tomography showed features of bowel ischemia which prompted surgical intervention. On exploration, she was found to have a large mesenteric defect with herniating ileum and ascending colon. A segment of gangrenous small bowel was resected. The mesenteric defect was repaired and the bowel tacked down to prevent volvulus. The patient made an uneventful recovery.
authors.affiliation: Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan.
authors.forename: Zia
authors.initials: Z
authors.lastname: ur Rehman
authors.forename: Sadaf
authors.initials: S
authors.lastname: Khan
mesh_terms: D015746:Abdominal Pain / Q000000981:diagnostic imaging / Q000601:surgery; D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D006547:Hernia / Q000151:congenital* / Q000000981:diagnostic imaging; D059685:Herniorrhaphy; D006801:Humans; D007082:Ileum / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D007415:Intestinal Obstruction / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D007421:Intestine, Small / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D008643:Mesentery / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D014057:Tomography, X-Ray Computed