Small bowel obstruction and necrosis caused by an internal hernia is a rare occurrence. Due to the variety of symptoms, the location of the hernias and the limited diagnostic means, the establishment of a preoperative diagnosis is very difficult. Here, we describe a unique case of intestinal obstruction caused by an internal hernia. The patient was admitted with acute abdominal pain without concurrent nausea or vomiting. There was no history of previous abdominal surgery or abdominal trauma. The preoperative examination showed a suspicious mass in the ascending colon. A diagnostic laparoscopy was performed and surprisingly revealed an incarcerated loop of small intestine in a peritoneal sac located in the right ventrolateral abdominal wall. Between the duplicate peritoneal membranes, a necrotized section of the ileum was discovered which was removed by laparotomy, followed by an end-to-end anastomosis. Although internal hernias are only very rarely the cause of acute intestinal obstructions, the possibility should always be kept in mind, particularly in patients who do not show external hernias or have no history of previous abdominal surgery or abdominal trauma.
- Duplicate parietal peritoneum
- Internal hernia
- Small bowel necrosis
- Small bowel obstruction
ASJC Scopus subject areas