Transmesenteric internal hernia

Discussion:

The patient proceeded to laparotomy, which confirmed the transmesenteric internal hernia. On imaging, the differential diagnosis is a left paraduodenal hernia but these are located more superiorly between the pancreas and stomach. The other possibility is prolapsed bowel under an adhesion. In adults, prior surgery, trauma or inflammation are the most common causes of transmesenteric hernias - this patient has had a prior appendectomy

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