Department of General Surgery, Prince Saud Bin Jalawy Hospital, AlMubarraz, Eastern Province, Saudi Arabia.
College of Medicine, King Faisal University, AlHofuf, Eastern Province, Saudi Arabia
BMJ Case Rep. 2023 Feb 16;16(2):e253578. doi: 10.1136/bcr-2022-253578.
Internal hernias are protrusions of viscera that can cause obstructions such as small bowel obstruction (SBO). Diagnosis can be challenging, as they usually come with an atypical presentation. We report on a case of a woman in her early 40s, with no history of surgery or chronic illnesses, which came with abdominal pain associated with vomiting. CT scan revealed obstructed small bowel. On exploratory laparoscopy, an internal hernia through a peritoneal defect in the vesicouterine space was found, entrapping a limb of the jejunum. The entrapped loop of the small bowel was freed, the ischaemic part was resected, and the defect was closed. Our case presents the second reported case of a congenital vesicouterine defect causing SBO. It is important to consider patients presenting with SBO as a case of congenital peritoneal defect if they had no previous surgeries.
内疝是内脏的突出物,可导致肠梗阻,如小肠梗阻 (SBO)。由于其表现通常不典型,因此诊断具有挑战性。我们报告了一例 40 岁出头的女性病例,无手术或慢性疾病史,伴有腹痛和呕吐。CT 扫描显示小肠梗阻。在剖腹腹腔镜检查中,发现通过脐尿管空间的腹膜缺陷处有内疝,嵌顿空肠的一段。嵌顿的小肠环被松解,缺血部分被切除,缺陷被关闭。我们的病例是第二例报道的先天性脐尿管缺陷导致 SBO 的病例。如果患者以前没有手术,那么对于出现 SBO 的患者,应考虑为先天性腹膜缺陷。