title: Mesenteric defect with internal herniation in the pediatric emergency department: an unusual presentation of acute abdomen.
abstract: Internal herniation is a rare cause of intestinal obstruction, especially in the emergency department. We report a child with acute abdomen resulting from transmesenteric internal herniation of the small bowel. Radiographic findings revealed gaseous distension of the bowel loops in the upper abdominal area with a paucity of gas in the lower abdomen. Operative finding showed gangrenous small bowel due to mesenteric defect with an internal herniation. The gangrenous bowel was resected and the patient was discharged with an uneventful outcome. We emphasize that early recognition of internal herniation warrants further evaluation and appropriate management.
authors.affiliation: Department of Pediatric, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Keelung, Taiwan; Graduate Institute of Clinical Medical Sciences, Chang Gung University, College of Medicine, Taoyuan, Taiwan; Department of General Pediatric, Chang Gung Children's Hospital and Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan.
authors.forename: Mei-Hua
authors.initials: MH
authors.lastname: Hu
authors.affiliation: Department of Anesthesiology, Tri-Service General Hospital, National Defense Medical Center, Nei-Hu, Taipei, Taiwan.
authors.forename: Go-Shine
authors.initials: GS
authors.lastname: Huang
authors.affiliation: Department of Pediatric Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Jeng-Chang
authors.initials: JC
authors.lastname: Chen
authors.affiliation: Department of General Pediatric, Chang Gung Children's Hospital and Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan. Electronic address: a65952@gmail.com.
authors.forename: Chang-Teng
authors.initials: CT
authors.lastname: Wu
mesh_terms: D000006:Abdomen, Acute / Q000209:etiology*; D002648:Child; D004636:Emergency Service, Hospital; D046449:Hernia, Abdominal / Q000150:complications*; D006801:Humans; D008297:Male; D008643:Mesentery / Q000002:abnormalities*; D014057:Tomography, X-Ray Computed
keywords: abdominal pain; children; internal hernia; mesenteric defect