Abstract: Background:A congenital mesenteric defect is very rare, but canpotentially cause internal hernia with consequent incarceration or strangulation ofthe small intestine.The incidence of mesenteric hernia, as reported by Shaffnerand Tennel19 in a series of autopsies, was found to be 0.2 to 0.9%.18Patient'smedical examination revealed the presence of internal hernias.Difficulty inreaching a definitive diagnosis due to non-specific clinical and imaging findingsoften cause life-threatening bowel ischemia. Case Presentagirl, without any remarkable antecedent history, presented to the hospitalwithprogressive abdominal pain in epigastric region, nauseous, and bilious vomitingoccurring three days before admission. Clinical examination abdominal findingwere distension with decreased bowel sounds and pain in deep palpation inepigastrium region. Discussion: The mesenteric defect is located 22 cm from theligament of Treitz. Her intestinal obstruction and strangulation were so complexthat resection required incision of the mesenterium. Her intestinal obstruction andstrangulation were so complex that resection required incision of themesenterium. Thus we proceeded with reduction of the bowel, small boweluntwisting, 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 prudentclosure of the peritoneal orifice in question.Early intervencorrection goes a long way in preventing high morbidity and mortality associatedwith cases of internal hernia.