Alhayo Sam, Gosal Preet, Shakeshaft Anthony
Department of Surgery, Nepean Hospital, Kingswood NSW 2747, Australia.
J Surg Case Rep. 2017 Jun 30;2017(6):rjx112. doi: 10.1093/jscr/rjx112. eCollection 2017 Jun.
Transmesenteric hernia is a rare cause of bowel obstruction and strangulation. It can be due to iatrogenic injury, trauma, inflammatory and less likely congenital. We present a case of true congenital transmesenteric hernia in a 26-year-old male with no previous surgical history or trauma. The patient presented acutely with no prior symptoms. Investigations provided limited information towards the diagnosis of the hernia, but suggestive of mid-gut volvulus. Emergency laparotomy was performed to find >75% of small bowel herniating through a proximal jejunal mesenteric defect leading to incarceration and early strangulation. No resection was required and patient recovered well. This case presents yet another rare pathology and highlights the importance of keeping a low threshold for operative intervention in uncertain cases.
肠系膜内疝是肠梗阻和肠绞窄的罕见原因。它可能由医源性损伤、创伤、炎症引起，先天性原因则较少见。我们报告一例26岁男性的真性先天性肠系膜内疝病例，该患者既往无手术史或外伤史。患者急性起病，此前无任何症状。检查对疝的诊断提供的信息有限，但提示中肠扭转。急诊行剖腹探查术，发现超过75%的小肠通过空肠近端肠系膜缺损疝出，导致肠管嵌顿和早期绞窄。无需进行肠切除，患者恢复良好。该病例展示了另一种罕见的病理情况，并强调了在不确定病例中对手术干预保持较低阈值的重要性。
