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Revision as of 04:39, 15 March 2009

Internal hernia

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Contributors: Cafer Zorkun M.D., PhD.

Please Take Over This Page and Apply to be Editor-In-Chief for this topic: There can be one or more than one Editor-In-Chief. You may also apply to be an Associate Editor-In-Chief of one of the subtopics below. Please mail us [2] to indicate your interest in serving either as an Editor-In-Chief of the entire topic or as an Associate Editor-In-Chief for a subtopic. Please be sure to attach your CV and or biographical sketch.

Overview

  • Protrusion of the viscera through the peritoneum or mesentery and into a compartment in the abdominal cavity.
  • Most common presentation is an acute intestinal obstruction of small bowel loops that develops through normal or abnormal apertures.
  • Responsible hernial orifices are usually preexisting anatomic structures, such as foramina, recesses, and fossae.
  • Pathologic defects of the mesentery and visceral peritoneum, which are caused by congenital mechanisms, surgery, trauma, inflammation, and circulation, are also potential herniation orifices.

Types of internal hernias

  • Foramen of Winslow
  • Paraduodenal
  • Transmesenteric
  • Transomental
  • Pericecal
  • Sigmoid mesocolon
  • Supravesical
  • Pelvic hernias

Diagnostic Findings

Computed Tomography

  • Encapsulation of distended bowel loops with an abnormal location, arrangement or crowding of small-bowel loops within the hernial sac, evidence of obstruction with segmental dilatation and stasis.
  • Mesenteric vessel abnormalities, with engorgement, crowding, twisting, and stretching of these vessels

Patient #1: Presents with intermittent abdominal pain. History of gastric bypass

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