Internal hernia

Internal hernia

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

Contributors: Cafer Zorkun M.D., PhD.

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Overview

• Protrusion of the viscera through the peritoneum or mesentery and into a compartment in the abdominal cavity.
• 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