Surgical Management of a Rare Case of Mesocolonic Internal Hernia through Congenital Defect in Ascending Mesocolon with Mesenteric Root Torsion

Abstract

Internal hernia is one of the rare causes of small intestine obstruction. Mesenteric torsion is also called as testinal volvulus, clinical presentation may show the small intestine rotates around the mesenteric root. Due to which the blood supply to the intestine may get blocked and can lead to sepsis and death. This is a life threatening condition. This conditon is often associated with previous surgeries or congenital abnormalities that creates twisting of intestine. A 29-year-old male patient came to the hospital with a complaint of abdominal pain for the last 13 hours, he has no remarkable history and no medication. He went to the emergency surgery department for further treatment and an emergency plain CT scan was performed that reported the mesenteric torsion. So he was admitted to the hospital for treatment of mesenteric torsion, while performing surgery hiatus in the ascending mesocolon was found that the small intestine was herniated at 720⁰. He was treated surgically the hiatus was closed (8 cm long), and the free ascending mesocolon was fixed to the posterior wall. In CT scan reports this defect is generally reported as non-specific changes of mesentery.