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Intersigmoid hernia

Case contributed by Bruno Di Muzio
Diagnosis almost certain

Presentation

Abdominal pain in lower abdomen for 1 day.

Patient Data

Age: 80 years
Gender: Male

CT Abdomen and pelvis

ct

There is distension of the small bowl with a suffering loop identified in the pelvic region. Following the end of this loop, it can be noticed that it seems to represent an internal hernia.  

Annotated image

Annotated image showing the point where it is felt to represent the neck of the internal herniation.

Case Discussion

This case represents an intersigmoid hernia, which is the most common type of sigmoid mesocolon hernias, it is an internal abdominal hernia that occurs in fossa intersigmoid 1. The intersigmoid fossa is a peritoneal pocket formed between two adjacent sigmoid segments and their mesentery 2

Intersigmoid hernias (including all three types of sigmoid mesocolon hernias) represent about 4 to 8% of internal hernias 2

This case was confirmed at surgery.

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