SMALL BOWEL STRANGULATION IN A CASE OF PRIMARY INTERNAL HERNIA- A RARE CASE REPORT

Dr. Karthik S.A; Dr Sandesh T.R; Dr Ashish Sahu; Dr Abdus Salam; Dr Subha Pandey

Volume : IX, Issue : VII, July - 2020

SMALL BOWEL STRANGULATION IN A CASE OF PRIMARY INTERNAL HERNIA- A RARE CASE REPORT

Dr. Karthik S. A, Dr Sandesh T. R, Dr Ashish Sahu, Dr Abdus Salam, Dr Subha Pandey

Abstract :

INTRODUCTION: An internal hernia (IH) is a protrusion of intestines or other abdominal organs through a normal or abnormal orifice in the peritoneum or mesentery, occasionally leading to strangulation or incarceration. IH has a reported autopsy incidence of 0.2 to 0.9% and is the cause of small bowel obstruction in 0.6 to 5.8% of the cases CASE DISCUSSION: 20 year old male patient presented with generalised abdominal pain, non -passage of stools and flatus and on examination guarding and board like rigidity with tender lower abdominal swelling noted. On Erect X ray abdomen multiple air fluids level noted. On exploratory laparotomy coiled loops of gangrenous ileum was noted. Loop of ileum was passing through the transmesenteric defect and which was noted to be the cause for strangulation. CONCLUSION: Internal hernias are rare but an important cause of intestinal obstruction given the high mortality associated if left untreated, nevertheless still often underdiagnosed. Primary internal hernias should be kept in the differential diagnosis of acute intestinal obstruction in adults with no previous history of surgery or trauma as it was seen with our case. Since physical examination findings are nonspecific clinical suspicion along with emergency CT plays an important role in the preoperative diagnosis of IH.