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International Journal of Advances In Case Reports

Volume 11, Issue 1, 2024
Mcmed International
International Journal of Advances In Case Reports
Issn
XXX-XXXX (Print), 2349 - 8005 (Online)
Frequency
bi-annual
Email
editorijacr@mcmed.us
Journal Home page
http://mcmed.us/about/ijacr
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Abstract
Title
POST-OPERATIVE OBSTRUCTED INTERNAL PARACECAL HERNIA THROUGH CONGENITAL MESENTERIC DEFECT PRESENTING AFTER TRANSVAGINAL SURGERY IN AN 83-YEAR-OLD LADY
Author
Cho Cho*1, Govani Dhaval2, Bako Abdulmalik2, Dhawan Vikram3 and Patel Ramnik4
Email
cho.cho.dr@gmail.com
keyword
Congenital, mesenteric, Hernia, Intestinal obstruction, Post-operative, Midgut, Malrotation, Paracecal.
Abstract
An 83 -year-old lady with a genital prolapse had undergone elective transvaginal hysterectomy with pelvic floor repair uneventfully. She developed features of intestinal obstruction after initial recovery. Plain abdominal radiograph and ultrasound suggested low small bowel obstruction which was confirmed by CT scan and gastrograffin follow through study. She underwent exploratory laparotomy at which a congenital mesenteric defect was found in the ileocecal region with internal herniation of the terminal ileal loops through it. The defect was enlarged and hernial contents were reduced. The constriction rings at entry and exit sites were over sewn and bowel was viable without any need for resection. Paracecal internal hernia with a congenital defect in the mesentery presenting in the post-operative period is rare, interesting and challenging. Preoperative diagnosis is usually difficult. Gastrointestinal studies with contrast media and abdominal CT are helpful. Early diagnosis and prompt intervention and appropriate treatment reduce morbidity and mortality.
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