A case of internal supravesical hernia

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  • 内膀胱上窩ヘルニアの1例
  • ショウレイ ナイ ボウコウ ジョウカヘルニア ノ 1レイ

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Abstract

A 70-year-old man was admitted to our hospital because of nausea and abdominal pain. We diagnosed the case as small bowel obstruction but this patient had no history of undergoing laparotomy. So he underwent an abdominal computed tomography (CT) scan and detected the cause of the small bowel obstruction. Abdominal CT scan showed that the dilated and looped small intestine was pushed in the anterior wall of the bladder in the left lower abdomen. Small bowel obstruction due to internal hernia was suspected but was not a confirmed diagnosis. There were no emergency findings, so a long tube was placed to decompress the bowel, and his clinical course was observed. However, it did not improve the small bowel obstruction and it indicated surgery. Upon laparotomy, the ileum was incarcerated into the left internal supravesical fossa and we diagnosed a case of internal supravesical hernia. The internal supravesical hernia is very rare and there has been no report of accurate preoperative diagnosis of this disease. We must carry out an abdominal CT scan while keeping the possibility of the disease in mind, and we will be able to make a correct diagnosis before surgery, if the characteristic CT findings shown in this case are visualized.

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