Inoue Daisuke, Tokuhara Katsuji, Matsuki Hitomi, Noda Ryuhei, Kataoka Naoki
Department of Surgery, Kishiwada Tokushukai Hospital, 4-27-1, Kamori-cho, Kishiwada, Osaka 596-8522, Japan.
Department of Lower Gastroenterological Surgery, Kishiwada Tokushukai Hospital, 4-27-1, Kamori-cho, Kishiwada, Osaka 596-8522, Japan.
Int J Surg Case Rep. 2025 Sep;134:111701. doi: 10.1016/j.ijscr.2025.111701. Epub 2025 Jul 18.
Internal hernia is a rare cause of intestinal obstruction, and transverse mesocolon hernia (TMH) is an extremely rare subtype of internal hernia.
We report the successful treatment of a TMH through an idiopathic transverse mesocolon defect (iTMD). A 50-year-old man was rushed to hospital with sudden onset of abdominal pain. Computed tomographic imaging showed an internal hernia with small bowel obstruction in the right upper abdomen. He underwent emergency surgery for suspected strangulated intestinal obstruction caused by internal hernia. Laparoscopic surgery revealed that the small intestine was incarcerated in the iTMD. The incarcerated small intestine was reduced without requiring resection, and the iTMD was closed with barbed suture.
TMHs are rare and often difficult to diagnose preoperatively. Early recognition using characteristic computed tomographic findings can facilitate timely laparoscopic intervention and avoid complications such as bowel necrosis.
Idiopathic TMH should be considered as a differential diagnosis in patients with an internal hernia and no history of surgery.
内疝是肠梗阻的罕见病因，横结肠系膜疝（TMH）是内疝的一种极其罕见的亚型。
我们报告了一例通过特发性横结肠系膜缺损（iTMD）成功治疗TMH的病例。一名50岁男性因突发腹痛被紧急送往医院。计算机断层扫描成像显示右上腹有内疝伴小肠梗阻。他因怀疑内疝导致绞窄性肠梗阻而接受了急诊手术。腹腔镜手术显示小肠嵌顿在iTMD中。嵌顿的小肠得以还纳，无需切除，iTMD用倒刺缝线关闭。
TMH罕见，术前常难以诊断。利用特征性的计算机断层扫描结果进行早期识别可促进及时的腹腔镜干预，并避免诸如肠坏死等并发症。
对于有内疝且无手术史的患者，应考虑特发性TMH作为鉴别诊断。
