Post-operative transmesosigmoid hernia causing small bowel obstruction: a case report

Internal hernia is an unusual cause of small bowel obstruction and classified several types according to locations. Transmesosigmoid hernia is rare type among others mesosigmoid hernia was rarely reported in the literature. We report the case of a 44-year-old male who presented with acute abdominal pain and developed a small intestinal obstruction. History, clinical and radiography examination were suggested intestinal obstruction due to postoperative adhesion. The diagnosis of small bowel obstruction due to internal hernia was confirmed by laparotomy exploration. The herniated loop was reduced successfully and the defect was approximated with interrupted sutures. The postoperative course was uneventful and the patient is free from symptoms and recurrence. This case report highlight difficulty and importance of high index of suspicion considering an internal hernia as a cause of small bowel obstruction in individuals of all age groups with or without a previous history of abdominal surgery.