腸閉塞をきたし術前診断した上行結腸間膜裂孔ヘルニアの１例

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  • A CASE OF TRANSMESOCOLIC HERNIA OF ASCENDING COLON

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An 80-year old man admitted for right lower abdominal pain was diagnosed as ileus based on abdominal X-ray examination. Abdominal computed tomography revealed significant dilatation of small intestines, but not the cause of ileus. Conservative therapy using a long tube was initiated. Intestinal contrast study through the tube showed strangulation of the small intestine, and internal hernia was diagnosed. An emergency operation was thus performed. The small intestine was incarcerated into the 3cm defect of mesothelium of the ascending colon. A partial resection of small intestine and closure of hernia were carried out. Though preoperative diagnosis of internal hernia is difficult, we should always keep it in mind and not miss the indication for operation.

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