Emergency surgery was performed. Intraoperative findings confirmed internal hernia with closed loop occlusion. At the moment of the surgery, there were incipient signs of bowel wall ischemia, so right colectomy was performed.

Mild abdominal discomfort in old population is quite common in the Emergency Room. In this case, an early suspicion of intestinal ischemia led to a CT scan and to an early surgical procedure, with good outcome to the patient.

Pericecal hernia is a rare subtype of internal hernia (6-13% of all internal hernias).

The characteristic finding is the existence of cluster of bowel loops (usually ileal) located posteriorly and laterally to the normal cecum. Extension into the right paracolic gutter is common.