Takayama Noriya, Takata Osamu, Ishioka Daisuke, Imai Ichiro, Yoshida Yoko, Sekiya Sakae
Arai Hospital, 2-2-28, Kukichuo, Kuki-shi, Saitama, 346-0003, Japan.
Arai Hospital, 2-2-28, Kukichuo, Kuki-shi, Saitama, 346-0003, Japan.
Int J Surg Case Rep. 2025 Sep 4;135:111902. doi: 10.1016/j.ijscr.2025.111902.
Transverse mesocolic hernia is an extremely rare type of internal hernia, with only a limited number of cases reported to date. In this case report, we present a geriatric patient with a transverse mesocolic hernia who was successfully treated with emergent laparoscopic surgery.
An 89-year-old male patient presented with abdominal pain and distension that had begun the previous day. He had multiple comorbidities, such as diabetes mellitus, hypertension, and prostate cancer. Additionally, he had been prescribed an antiplatelet agent for a history of cerebral infarction. He had no previous abdominal surgery except for an appendectomy at a young age. Computed tomography revealed a closed-loop obstruction of the ileum on the right side of the superior mesenteric vein. Emergent laparoscopy revealed incarceration of the small intestine through a defect in the transverse mesocolon, which was successfully reduced. The postoperative course was uneventful, and the patient was discharged without any decline in activities of daily living.
First, this was an extremely rare case of internal hernia that required emergent surgical intervention. Second, minimally invasive surgery was successfully performed, contributing to a rapid postoperative recovery, despite the patient being geriatric and having multiple surgical risk factors.
We managed a case of transverse mesocolic hernia. This case report provides valuable insights into the clinical course of the disease and the effectiveness of emergent laparoscopic reduction in geriatric patients.
横结肠系膜疝是一种极为罕见的内疝类型，迄今为止仅有少数病例报道。在本病例报告中，我们介绍了一名患有横结肠系膜疝的老年患者，该患者通过急诊腹腔镜手术获得成功治疗。
一名89岁男性患者因前一日开始出现腹痛和腹胀前来就诊。他患有多种合并症，如糖尿病、高血压和前列腺癌。此外，因有脑梗死病史，他一直在服用抗血小板药物。除年轻时做过阑尾切除术外，他既往无腹部手术史。计算机断层扫描显示肠系膜上静脉右侧回肠出现闭袢性梗阻。急诊腹腔镜检查发现小肠通过横结肠系膜的一个缺损处发生嵌顿，随后成功复位。术后过程顺利，患者出院时日常生活活动能力未出现任何下降。
首先，这是一例极为罕见的需要急诊手术干预的内疝病例。其次，尽管患者为老年且存在多种手术风险因素，但仍成功实施了微创手术，促进了术后快速康复。
我们处理了一例横结肠系膜疝病例。本病例报告为该疾病的临床过程以及老年患者急诊腹腔镜复位的有效性提供了有价值的见解。
