title: Jejunal obstruction due to a variant of transmesocolic hernia: a rare presentation of an acute abdomen.
abstract: BACKGROUND
  Internal hernias include paraduodenal, pericecal, through foramen of Winslow, intersigmoid and retroanastomotic hernias. These hernias could be either congenital or acquired after abdominal surgery. They account for approximately 0.5-5 % of all cases of intestinal obstruction.
  
  
  METHODS
  A 48-year-old female was admitted to casualty with a history of abdominal distension and vomiting of 3 days duration. An abdominal X-ray supine film showed multiple small bowel loops with air fluid levels. On surgery she was found to have a transmesocolic hernia. The defect in the transverse mesocolon was repaired.
  
  
  CONCLUSIONS
  The clinical signs and symptoms of lesser sac hernia are non-specific. These rare lesser sac hernias can be lethal. Therefore, immediate diagnosis and surgery is essential. Although a rare entity, they account for significant mortality form intestinal obstruction. We report an extremely rare case of an internal abdominal hernia through the transverse mesocolon, in a young woman.
authors.affiliation: General Surgery, University Surgical Unit, The National Hospital of Sri Lanka, Colombo, Sri Lanka.
authors.forename: Duminda
authors.initials: D
authors.lastname: Subasinghe
authors.affiliation: Gastrointestinal Surgery, University Surgical Unit, The National Hospital of Sri Lanka, Colombo, Sri Lanka.
authors.forename: Chathuranga Tisara
authors.initials: CT
authors.lastname: Keppetiyagama
authors.affiliation: University Surgical Unit, The National Hospital of Sri Lanka, 28/1, Ishwari road, Colombo 06, Colombo, Sri Lanka. samarasekera58@yahoo.co.uk.
authors.forename: Dharmabandhu N
authors.initials: DN
authors.lastname: Samarasekera
mesh_terms: D000006:Abdomen, Acute / Q000209:etiology*; D005260:Female; D006547:Hernia / Q000150:complications / Q000175:diagnosis*; D059685:Herniorrhaphy; D006801:Humans; D007415:Intestinal Obstruction / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D007579:Jejunal Diseases / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D008646:Mesocolon / Q000601:surgery; D008875:Middle Aged; D010532:Peritoneal Diseases / Q000150:complications / Q000175:diagnosis*