Case Report
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World J Gastroenterol. May 21, 2014; 20(19): 5924-5929
Published online May 21, 2014. doi: 10.3748/wjg.v20.i19.5924
Transmesosigmoid hernia: Case report and review of literature
Bin Li, Akram Assaf, Yun-Guo Gong, Lian-Zhong Feng, Xue-Yong Zheng, Chao-Neng Wu
Bin Li, Lian-Zhong Feng, Xue-Yong Zheng, Department of General Surgery, the Second Hospital of Jiaxing, Jiaxing 314000, Zhejiang Province, China
Akram Assaf, Saudi Red Crescent Authority, Dammam 31129, Saudi Arabia
Yun-Guo Gong, Chao-Neng Wu, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai 200032, China
Chao-Neng Wu, Institute of Biomedical Science, Fudan University, Shanghai 200032, China
Author contributions: Li B, Wu CN, Feng LZ and Zheng XY designed the research; Assaf A and Gong YG analyzed data; Wu CN, Assaf A, Gong YG and Li B wrote the paper.
Supported by General Program (Key Program, Major Research Plan) of National Natural Science Foundation of China, No. 81230007; National Basic Research Program of China, No. 2011CB503905; and National Natural Science Foundation of China, No. 81200147
Correspondence to: Chao-Neng Wu, MD, PhD, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, 180 Feng Lin Road, Shanghai 200032, China. wuchao1107@126.com
Telephone: 86-21-64041990 Fax: 86-21-64223006
Received: January 3, 2014
Revised: February 14, 2014
Accepted: March 5, 2014
Published online: May 21, 2014
Processing time: 135 Days and 13.1 Hours
Abstract

Transmesosigmoid hernia has previously been considered as a rare condition. The clinical symptoms can be nonspecific. Here, we report a case of acute intestinal obstruction because of transmesosigmoid hernia. In addition, after a comprehensive review of PubMed and China National Knowledge Infrastructure, we present a review of 22 cases of transmesosigmoid hernia. We summarize several valuable clinical features that help early recognition of transmesosigmoid hernia. As a result of easy strangulation, in patients without a history of surgery or abdominal inflammation who present with symptoms of progressive or persistent small bowel obstruction (SBO), surgeons should consider the possibility of transmesosigmoid hernia. In addition, based on our data, in patients with SBO because of transmesosigmoid hernia, the defect is usually 2-5 cm in diameter. Furthermore, because of the high risk of strangulation with transmesosigmoid hernia, it is mandatory to reassess the condition timely and periodically when patients receive conservative treatment.

Keywords: Transmesosigmoid hernia; Acute intestinal obstruction; Internal hernia

Core tip: Transmesosigmoid hernia is a rare condition. We report a case of transmesosigmoid hernia. In addition, we carried out a comprehensive literature analysis and summarized the important clinical traits. Our data indicated for the first time that small bowel obstruction due to transmesosigmoid hernia can easily lead to strangulation, with the defect being 2-5 cm in diameter. It is necessary to reassess the condition timely and periodically if patients receive conservative treatment.