Alagoa João Ana, Aparício David, João Pedro, Pignatelli Nuno, Nunes Vítor
General Surgery Department, Hospital Prof. Doutor Fernando Fonseca, EPE ,IC 19, 2720-276 Amadora, Portugal.
Radiology Department, Hospital Prof. Doutor Fernando Fonseca, EPE, Portugal.
Radiol Case Rep. 2021 Dec 28;17(3):717-720. doi: 10.1016/j.radcr.2021.12.014. eCollection 2022 Mar.
Transomental internal hernias are a rare cause of intestinal obstruction and most commonly iatrogenic, resulting from previous surgical interventions, abdominal trauma or inflammation. Occasionally, they may occur spontaneously. We report the case of a 44-year-old healthy male admitted to the emergency room with acute abdominal pain and vomiting, consistent with intestinal obstruction. An internal hernia of small bowel in the lesser sac was suspected after performing a computed tomography (CT) scan and emergent laparotomy confirmed herniation of a jejunal loop through a defect in the hepatogastric ligament, resulting in strangulation and requiring enterectomy. The patient had a favourable outcome and was discharged a few days after surgery. Both radiologists and surgeons must be aware of rare internal hernia subtypes, to avoid delays in diagnosis and treatment. Abdominal CT is the first-line imaging of choice, providing useful diagnostic hallmarks. Nevertheless, surgical exploration is typically essential to confirm the diagnosis, identify the defect and assess bowel viability.
经网膜内疝是肠梗阻的罕见病因，最常见为医源性，由既往手术干预、腹部创伤或炎症引起。偶尔，也可能自发发生。我们报告一例44岁健康男性因急性腹痛和呕吐入院急诊，症状符合肠梗阻。计算机断层扫描（CT）检查后怀疑小网膜囊内小肠内疝，急诊剖腹探查证实一段空肠袢通过肝胃韧带缺损处疝入，导致肠绞窄，需行肠切除术。患者预后良好，术后数天出院。放射科医生和外科医生都必须了解罕见的内疝亚型，以避免诊断和治疗延误。腹部CT是首选的一线影像学检查，可提供有用的诊断特征。然而，手术探查通常对于确诊、识别缺损和评估肠管活力至关重要。
