Transmesocolic herniation of small bowel following colonic interposition.

This report focuses on iatrogenic transmesocolic hernia causing small bowel obstruction following colonic interposition. Of 45 patients undergoing visceral esophageal substitution using colon, three developed small bowel obstruc. tion due to internal herniation of a loop of small boweI through a defect in the mesocolon. Awareness of this unique cause of small bowel obstruction following colonic interposition and institution of early surgical treatment will prevent irreparable intestinal damage associated with internal liernias. ACKNOWLEDGEMENT The authors thank Mark B. Orringer, M.D., Department of Surgery, Section of Thoracic Surgery for his kind permission to report on these patients, and Ms Juanita Cantrell for meticulously typing this manuscript.