Closed Loop Obstruction from Epiploic Appendage Adhesion Mimicking Pericecal Internal Hernia

Internal hernias involve herniation of viscera into an abdominal compartment through a defect in the mesentery or peritoneum. Herniation may occur through normal anatomic structures or through pathologic defects secondary to congenital abnormality, inflammation, trauma, or surgery. Patients with an...

Full description

Saved in:
Bibliographic Details
Main Authors: Fatima Sharif, Paul Samuel Sander, Ali Sharif, Grace Montenegro, Robert Garrett
Format: Article
Language:English
Published: Wiley 2018-01-01
Series:Case Reports in Radiology
Online Access:http://dx.doi.org/10.1155/2018/4767516
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850215187698679808
author Fatima Sharif
Paul Samuel Sander
Ali Sharif
Grace Montenegro
Robert Garrett
author_facet Fatima Sharif
Paul Samuel Sander
Ali Sharif
Grace Montenegro
Robert Garrett
author_sort Fatima Sharif
collection DOAJ
description Internal hernias involve herniation of viscera into an abdominal compartment through a defect in the mesentery or peritoneum. Herniation may occur through normal anatomic structures or through pathologic defects secondary to congenital abnormality, inflammation, trauma, or surgery. Patients with an internal hernia most commonly present with acute bowel obstruction. While internal hernia is an uncommon cause of bowel obstruction, making up approximately 0.2-0.9% of cases (Choi, 2017), the incidence is increasing due to greater use of techniques such as Roux-en-Y for liver transplant and gastric bypass. There are multiple types of internal hernia, including paraduodenal, Foramen of Winslow, sigmoid mesocolon, pericecal, transmesenteric, transomental, supravesical, and pelvic. We present a case in which a transverse colon epiploic appendage adhesion to the ascending colon mesentery resulted in a closed loop obstruction mimicking a pericecal internal hernia. Radiologists should be aware of the imaging findings of closed loop obstruction related to internal hernia and maintain a high index of suspicion in patients with history of prior abdominal surgery presenting with bowel obstruction. It is useful for radiologists to understand that adhesions may result in internal hernias, which mimic the classically described categories.
format Article
id doaj-art-84f766c2bcce4c8c9ee8a97ab695b30e
institution OA Journals
issn 2090-6862
2090-6870
language English
publishDate 2018-01-01
publisher Wiley
record_format Article
series Case Reports in Radiology
spelling doaj-art-84f766c2bcce4c8c9ee8a97ab695b30e2025-08-20T02:08:42ZengWileyCase Reports in Radiology2090-68622090-68702018-01-01201810.1155/2018/47675164767516Closed Loop Obstruction from Epiploic Appendage Adhesion Mimicking Pericecal Internal HerniaFatima Sharif0Paul Samuel Sander1Ali Sharif2Grace Montenegro3Robert Garrett4University of Missouri Kansas City School of Medicine, 2411 Holmes Street, Kansas City, Missouri 64108, USASaint Louis University School of Medicine, 3635 Vista Blvd., St. Louis, MO 63110, USASaint Louis University School of Medicine, 3635 Vista Blvd., St. Louis, MO 63110, USASaint Louis University School of Medicine, 3635 Vista Blvd., St. Louis, MO 63110, USASaint Louis University School of Medicine, 3635 Vista Blvd., St. Louis, MO 63110, USAInternal hernias involve herniation of viscera into an abdominal compartment through a defect in the mesentery or peritoneum. Herniation may occur through normal anatomic structures or through pathologic defects secondary to congenital abnormality, inflammation, trauma, or surgery. Patients with an internal hernia most commonly present with acute bowel obstruction. While internal hernia is an uncommon cause of bowel obstruction, making up approximately 0.2-0.9% of cases (Choi, 2017), the incidence is increasing due to greater use of techniques such as Roux-en-Y for liver transplant and gastric bypass. There are multiple types of internal hernia, including paraduodenal, Foramen of Winslow, sigmoid mesocolon, pericecal, transmesenteric, transomental, supravesical, and pelvic. We present a case in which a transverse colon epiploic appendage adhesion to the ascending colon mesentery resulted in a closed loop obstruction mimicking a pericecal internal hernia. Radiologists should be aware of the imaging findings of closed loop obstruction related to internal hernia and maintain a high index of suspicion in patients with history of prior abdominal surgery presenting with bowel obstruction. It is useful for radiologists to understand that adhesions may result in internal hernias, which mimic the classically described categories.http://dx.doi.org/10.1155/2018/4767516
spellingShingle Fatima Sharif
Paul Samuel Sander
Ali Sharif
Grace Montenegro
Robert Garrett
Closed Loop Obstruction from Epiploic Appendage Adhesion Mimicking Pericecal Internal Hernia
Case Reports in Radiology
title Closed Loop Obstruction from Epiploic Appendage Adhesion Mimicking Pericecal Internal Hernia
title_full Closed Loop Obstruction from Epiploic Appendage Adhesion Mimicking Pericecal Internal Hernia
title_fullStr Closed Loop Obstruction from Epiploic Appendage Adhesion Mimicking Pericecal Internal Hernia
title_full_unstemmed Closed Loop Obstruction from Epiploic Appendage Adhesion Mimicking Pericecal Internal Hernia
title_short Closed Loop Obstruction from Epiploic Appendage Adhesion Mimicking Pericecal Internal Hernia
title_sort closed loop obstruction from epiploic appendage adhesion mimicking pericecal internal hernia
url http://dx.doi.org/10.1155/2018/4767516
work_keys_str_mv AT fatimasharif closedloopobstructionfromepiploicappendageadhesionmimickingpericecalinternalhernia
AT paulsamuelsander closedloopobstructionfromepiploicappendageadhesionmimickingpericecalinternalhernia
AT alisharif closedloopobstructionfromepiploicappendageadhesionmimickingpericecalinternalhernia
AT gracemontenegro closedloopobstructionfromepiploicappendageadhesionmimickingpericecalinternalhernia
AT robertgarrett closedloopobstructionfromepiploicappendageadhesionmimickingpericecalinternalhernia