Internal hernia

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	Internal hernia;
	Computed Tomography: Internal hernia Image courtesy of RadsWiki

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Contributors: Cafer Zorkun M.D., PhD.

Overview

Protrusion of the viscera through the peritoneum or mesentery and into a compartment in the abdominal cavity. ^[1] ^[2]
Most common presentation is an acute intestinal obstruction of small bowel loops that develops through normal or abnormal apertures.
Responsible hernial orifices are usually preexisting anatomic structures, such as foramina, recesses, and fossae.
Pathologic defects of the mesentery and visceral peritoneum, which are caused by congenital mechanisms, surgery, trauma, inflammation, and circulation, are also potential herniation orifices.

Types of internal hernias

Foramen of Winslow
Paraduodenal
Transmesenteric
Transomental
Pericecal
Sigmoid mesocolon
Supravesical
Pelvic hernias

Diagnostic Findings

Computed Tomography

Encapsulation of distended bowel loops with an abnormal location, arrangement or crowding of small-bowel loops within the hernial sac, evidence of obstruction with segmental dilatation and stasis.
Mesenteric vessel abnormalities, with engorgement, crowding, twisting, and stretching of these vessels

Patient #1: Patient presents with intermittent abdominal pain. The patient had a history of gastric bypass

Images courtesy of RadsWiki

References

↑ Martin, Lucie C., Merkle, Elmar M., Thompson, William M. Review of Internal Hernias: Radiographic and Clinical Findings. Am. J. Roentgenol. 2006 186: 703-717.
↑ Nobuyuki Takeyama, Takehiko Gokan, Yoshimitsu Ohgiya, Shuichi Satoh, Takashi Hashizume, Kiyoshi Hataya, Hiroshi Kushiro, Makoto Nakanishi, Mitsuo Kusano, and Hirotsugu Munechika. CT of Internal Hernias. RadioGraphics 2005 25: 997-1015.

External Links

Goldminer: Internal hernia

Template:Skin and subcutaneous tissue symptoms and signs Template:Nervous and musculoskeletal system symptoms and signs Template:Urinary system symptoms and signs Template:Cognition, perception, emotional state and behaviour symptoms and signs Template:Speech and voice symptoms and signs Template:General symptoms and signs

Template:WikiDoc Sources

[1] Martin, Lucie C., Merkle, Elmar M., Thompson, William M. Review of Internal Hernias: Radiographic and Clinical Findings. Am. J. Roentgenol. 2006 186: 703-717.

[2] Nobuyuki Takeyama, Takehiko Gokan, Yoshimitsu Ohgiya, Shuichi Satoh, Takashi Hashizume, Kiyoshi Hataya, Hiroshi Kushiro, Makoto Nakanishi, Mitsuo Kusano, and Hirotsugu Munechika. CT of Internal Hernias. RadioGraphics 2005 25: 997-1015.

[1]

[2]

v t e Symptoms and signs: circulatory (R00–R03, 785)
Cardiovascular	Template:Navbox subgroup
Myeloid/blood	Template:Navbox subgroup

v t e Symptoms and signs: respiratory system (R04–R07, 786)
Hemorrhage	Epistaxis Hemoptysis
Abnormalities of breathing	Respiratory sounds Stridor Wheeze Crackles Rhonchi Hamman's sign Apnea Dyspnea Hyperventilation/Hypoventilation Hyperpnea/Tachypnea/Hypopnea/Bradypnea Orthopnea/Platypnea Trepopnea Biot's respiration Cheyne-Stokes respiration Kussmaul breathing Hiccup Mouth breathing/Snoring Breath-holding
Other	Asphyxia Cough Pleurisy Sputum Respiratory arrest Hypercapnia/Hypocapnia Pectoriloquy: Whispered pectoriloquy Egophony Bronchophony Pleural friction rub Fremitus Silhouette sign
Chest, general	Chest pain Precordial catch syndrome

v t e Symptoms and signs: digestive system and abdomen (R10–R19, 787,789)
GI tract	Template:Navbox subgroup
Accessory	Hepatosplenomegaly/Hepatomegaly Jaundice
Abdominopelvic	Ascites
Abdominal – general	Abdominal pain (Acute abdomen, Colic, Baby colic) Splenomegaly Abdominal guarding · Abdominal mass · Rebound tenderness Shifting dullness · Bulging flanks · Puddle sign · Fluid wave test

v t e Symptoms and signs: Symptoms concerning nutrition, metabolism and development (R62–R64, 783)
Ingestion/Weight	decrease: Anorexia • Weight loss/Cachexia/Underweight increase: Polyphagia • Polydipsia • Orexigenia • Weight gain
Growth	Delayed milestone • Failure to thrive • Short stature (e.g., Idiopathic)

Internal hernia

Contents

Overview

Types of internal hernias

Diagnostic Findings

Computed Tomography

References

External Links

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Internal hernia
Computed Tomography: Internal hernia Image courtesy of RadsWiki