Zheng XX, Wang KP, Xiang CM, Jin C, Zhu PF, Jiang T, Li SH, Lin YZ. Intestinal gangrene secondary to congenital transmesenteric hernia in a child misdiagnosed with gastrointestinal bleeding: A case report. World J Clin Cases 2021; 9(19): 5294-5301 [PMID: 34307581 DOI: 10.12998/wjcc.v9.i19.5294]
Corresponding Author of This Article
Yong-Zhi Lin, MD, Professor, Department of Pediatric Surgery, Taizhou Central Hospital (Taizhou University Hospital), No. 999 Donghai Avenue, Jiaojiang District, Taizhou 318000, Zhejiang Province, China. linyz@tzzxyy.com
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Jul 6, 2021; 9(19): 5294-5301 Published online Jul 6, 2021. doi: 10.12998/wjcc.v9.i19.5294
Intestinal gangrene secondary to congenital transmesenteric hernia in a child misdiagnosed with gastrointestinal bleeding: A case report
Xi-Xi Zheng, Kun-Peng Wang, Chao-Mei Xiang, Chong Jin, Peng-Fei Zhu, Teng Jiang, Shi-Hui Li, Yong-Zhi Lin
Xi-Xi Zheng, Chao-Mei Xiang, Peng-Fei Zhu, Teng Jiang, Shi-Hui Li, Yong-Zhi Lin, Department of Pediatric Surgery, Taizhou Central Hospital (Taizhou University Hospital), Taizhou 318000, Zhejiang Province, China
Kun-Peng Wang, Chong Jin, Department of General Surgery, Taizhou Central Hospital (Taizhou University Hospital), Taizhou 318000, Zhejiang Province, China
Author contributions: Zheng XX, Lin YZ, and Wang KP designed this study and wrote the manuscript; Xiang CM, Jin C, and Zhu PF collected the patient’s clinical data; Jiang T and Li SH reviewed the literature; Zheng XX, Wang KP, and Lin YZ revised the manuscript; all authors read and approved the final manuscript.
Supported byZhejiang Province Public Welfare Technology Application Research Project, No. LGF21H160022; and Project of Taizhou Central Hospital, No. 2019KT003.
Informed consent statement: Informed written consent was obtained from the patient and legal guardian for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to report.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yong-Zhi Lin, MD, Professor, Department of Pediatric Surgery, Taizhou Central Hospital (Taizhou University Hospital), No. 999 Donghai Avenue, Jiaojiang District, Taizhou 318000, Zhejiang Province, China. linyz@tzzxyy.com
Received: February 13, 2021 Peer-review started: February 13, 2021 First decision: March 14, 2021 Revised: March 16, 2021 Accepted: April 23, 2021 Article in press: April 23, 2021 Published online: July 6, 2021 Processing time: 130 Days and 18.2 Hours
Abstract
BACKGROUND
Congenital transmesenteric hernia in children is a rare and potentially fatal form of internal abdominal hernia, and no specific clinical symptoms can be observed preoperatively. Therefore, this condition is not widely known among clinicians, and it is easily misdiagnosed, resulting in disastrous effects.
CASE SUMMARY
This report presents the case of a 13-year-old boy with a chief complaint of abdominal pain and vomiting and a history of duodenal ulcer. The patient was misdiagnosed with gastrointestinal bleeding and treated conservatively at first. Then, the patient’s symptoms were aggravated and he presented in a shock-like state. Computed tomography revealed a suspected internal hernia, extensive small intestinal obstruction, and massive effusion in the abdominal and pelvic cavity. Intraoperative exploration found a small mesenteric defect approximately 3.5 cm in diameter near the ileocecal valve, and there was about 1.8 m of herniated small intestine that was treated by resection and anastomosis. The patient recovered well and was followed for more than 5 years without developing short bowel syndrome.
CONCLUSION
In this report, we review the pathogenesis, presentation, diagnosis, and treatment of congenital transmesenteric hernia in children.
Core Tip: Congenital transmesenteric hernia in children is a rare and challenging disease that usually lacks specific clinical symptoms, hindering a correct preoperative diagnosis. Here, we first report an interesting case of intestinal gangrene secondary to congenital transmesenteric hernia in a child misdiagnosed with gastrointestinal bleeding, with the purpose of generalizing and reviewing the pathogenesis, presentation, diagnosis, and treatment of congenital transmesenteric hernia in children. This case highlights that computed tomography examinations are helpful for improving the accurate preoperative diagnosis of congenital transmesenteric hernia. Surgery is a safe and effective choice for the treatment of congenital transmesenteric hernia.
