title: Small bowel obstruction caused by congenital transmesenteric defect.
abstract: Transmesenteric hernias are extremely rare. A strangulated hernia through a mesenteric opening is a rare operative finding. Preoperative diagnosis still is difficult in spite of the imaging techniques currently available. The authors describe two cases of paediatric patients presenting with bowel obstruction resulting from a congenital mesenteric hernia. The first patient had a 3-cm wide congenital defect in the ileal mesentery through which the sigmoid colon had herniated. The second patient is a newborn infant who presented with symptoms and radiographic evidence of neonatal occlusion. At surgical exploration, a long segment of the small bowel had herniated in a defect in the ileal mesentery. A brief review of epidemiology and anatomy of transmesenteric hernias is included, along with a discussion of the difficulties in diagnosis and treatment of this condition.
authors.affiliation: Department of Pediatric Surgery, Children's Hospital, Tunis, Tunisia. nouirafaouzi@yahoo.fr
authors.forename: F
authors.initials: F
authors.lastname: Nouira
authors.forename: Ben M
authors.initials: BM
authors.lastname: Dhaou
authors.forename: A
authors.initials: A
authors.lastname: Charieg
authors.forename: S
authors.initials: S
authors.lastname: Ghorbel
authors.forename: S
authors.initials: S
authors.lastname: Jlidi
authors.forename: B
authors.initials: B
authors.lastname: Chaouachi
mesh_terms: D000714:Anastomosis, Surgical; D002648:Child; D012809:Colon, Sigmoid / Q000000981:diagnostic imaging / Q000601:surgery; D003125:Colostomy; D005260:Female; D046449:Hernia, Abdominal / Q000150:complications* / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D007077:Ileal Diseases / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D007082:Ileum / Q000000981:diagnostic imaging / Q000601:surgery; D007415:Intestinal Obstruction / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D007813:Laparotomy; D008643:Mesentery / Q000002:abnormalities* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome