Abstrait

Transmesenteric internal hernia with sac and volvulus in a 7-month infant with multiple and recurrent episodes of abdominal pain and vomiting: A case report.

Ashjaei Bahar*, Foroutan Pooria, Sherafati Alborz

Background: Transmesenteric hernia is a rare cause of bowel obstruction, especially in children. Congenital etiologies of internal hernia are so rare that are usually published as case reports. With no previous history of trauma, surgery, it seems that trans mesenteric hernia in low ages is due to a congenital etiology. Generally, in congenital situation, the defect is in mesentery of ileum terminal, as was described in this case. Based on a classification that Armstrong et al. published in 2007, internal hernias are classified into three groups, based on the orifice. Transmesenteric hernia is in the group with the abnormal orifice due to "a congenital hole in a mesentery or a ligament. Case presentation: An infant is presented in this article, with the complaint of abdominal pain, vomiting, and abdominal distention. This infant had multiple and recurrent episodes of cramping abdominal pain and vomiting from neonatal period that were resolved after 1-2 hours itch time. Signs of bowel obstruction were detected in plain abdominal X-ray and abdomen ultrasonography, and the patient went under surgery. Transmesenteric internal hernia with hernia sac, accompanying with volvulus was seen after exploration. The patient was discharged in good condition. Conclusion: We must consider congenital internal hernia as a cause of intestinal obstruction in any case with episode of partial or complete intestinal obstruction however it isn’t very common but can be life threatening and lethal.