Abstract: Background:A congenital mesenteric defect is very rare, but can
potentially cause internal hernia with consequent incarceration or strangulation of
the small intestine.The incidence of mesenteric hernia, as reported by Shaffner
and Tennel19 in a series of autopsies, was found to be 0.2 to 0.9%.18Patient's
medical examination revealed the presence of internal hernias.Difficulty in
reaching a definitive diagnosis due to non-specific clinical and imaging findings
often cause life-threatening bowel ischemia. Case Presenta
girl, without any remarkable antecedent history, presented to the hospitalwith
progressive abdominal pain in epigastric region, nauseous, and bilious vomiting
occurring three days before admission. Clinical examination abdominal finding
were distension with decreased bowel sounds and pain in deep palpation in
epigastrium region. Discussion: The mesenteric defect is located 22 cm from the
ligament of Treitz. Her intestinal obstruction and strangulation were so complex
that resection required incision of the mesenterium. Her intestinal obstruction and
strangulation were so complex that resection required incision of the
mesenterium. Thus we proceeded with reduction of the bowel, small bowel
untwisting, and closure of the mesenteric defectfollowed by primary anastomosis.
Conclusion: Internal hernia is one of the rare causes of small bowel obstruction.
Treatment involves repositioning of the intestinal loops at all times and prudent
closure of the peritoneal orifice in question.Early interven
correction goes a long way in preventing high morbidity and mortality associated
with cases of internal hernia.
