1.A Transmesenteric Hernia in a Child: Gangrene of a Long Segment of Small Bowel through a Large Mesenteric Defect.
Chan Yong PARK ; Jung Chul KIM ; Soo Jin CHOI ; Shin Kon KIM
The Korean Journal of Gastroenterology 2009;53(5):320-323
Intestinal obstruction is a common surgical emergency. Transmesenteric hernia is an unusual cause of bowel obstruction that may result in irreversible damage of the bowel and a fatal outcome. Once incarceration of the bowel occurs, strangulation and gangrene follow immediately. The mortality rate associated with this condition is about 15%, but in the presence of gangrene of the bowel, the mortality rate is more than 50%. An accurate preoperative diagnosis of a transmesenteric hernia is very difficult and rarely made. Therefore, in patients with small bowel obstruction, in the absence of a history of previous surgery to suggest adhesions or an external hernia, the possibility of a transmesenteric hernia must be considered. We describe a case with gangrene of a long segment of the small bowel caused by a transmesenteric hernia through a large defect of small bowel mesentery in a child.
Child
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Diagnosis, Differential
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Female
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Gangrene
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Hernia/complications/*diagnosis/radiography
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Humans
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Ileal Diseases/*diagnosis/radiography/surgery
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Intestinal Obstruction/etiology/radiography
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Intestine, Small/*pathology/surgery
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Mesentery
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Tomography, X-Ray Computed
2.A Case of Left-sided Morgagni Hernia Complicating Incarcerated Small Bowel Hernia.
Se Won KIM ; Sang Hun JUNG ; Su Hwan KANG
The Korean Journal of Gastroenterology 2008;51(1):52-55
Morgagni hernia is an uncommon presentation representing about 3% in incidene and usually located in the right-sided anterior diaphragm. We experienced a case of Morgagni hernia in a seventy four-year-old male who was admitted complaining of intermittent abdominal pain. The diagnosis was made initially by chest and abdominal radiography, and an incarcerated Morgagni hernia was finally diagnosed with abdominal CT scans. Emergent laparotomy was performed. Morgagni foramen was located on the left-sided anterior diaphragm and Morgagni hernia which contained greater omentum and strangulated small intestine was gently reducted. Morgagni foramen measuring 4x5 cm was repaired with a Gortex mesh. We reported the experience of left-sided Morgagni hernia complicating incarcerated small bowel hernia in an old male patient.
Aged
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Hernia, Diaphragmatic/diagnosis/etiology/*radiography
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Humans
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Intestinal Obstruction/complications/*diagnosis
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*Intestine, Small
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Male
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Tomography, X-Ray Computed
4.A Case of Acute Pancreatitis due to Afferent Loop Syndrome with Internal Hernia.
Jong Won PARK ; Jin Heon LEE ; Sung Jun KIM ; Hye Won PARK ; Hyoung Su KIM ; Woon Geon SHIN ; Kyung Ho KIM ; Hak Yang KIM
The Korean Journal of Gastroenterology 2011;57(3):194-197
Acute pancreatitis and afferent loop syndrome (ALS) have similar symptoms and physical findings. Accurate early diagnosis is essential, as the management of acute pancreatitis is predominantly conservative whereas ALS usually requires surgery. We experienced one case of pancreatitis due to ALS with internal hernia. Laboratory findings of patient showed elevated serum amylase, lipase and WBC count. One day after admission, diagnosis was modified as acute pancreatitis caused by ALS on computed tomography. Patient was managed with surgical treatment and operation finding revealed ALS due to internal hernia. He was recovered well after surgical treatment and discharged without significant sequelae.
Acute Disease
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Afferent Loop Syndrome/complications/*diagnosis/surgery
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Endoscopy, Gastrointestinal
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Gallstones
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Hernia, Abdominal/*complications
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Humans
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Male
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Middle Aged
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Pancreatitis/*diagnosis/etiology
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Radiography, Abdominal
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Tomography, X-Ray Computed
5.Perforated Sigmoid Colon Cancer within an Irreducible Inguinal Hernia: a Case Report.
Kai Hsiung KO ; Chih Yung YU ; Chien Chang KAO ; Shih Hung TSAI ; Guo Shu HUANG ; Wei Chou CHANG
Korean Journal of Radiology 2010;11(2):231-233
A perforated sigmoid colon cancer within an inguinal hernia is extremely rare. This unexpected finding is usually discovered during surgery and causes an unavoidable septic evolution. Here, we describe the case of an 84-year-old man who presented with fever, abdominal distension, and a painful, enlarged, left scrotum. A CT showed a left, incarcerated, inguinal hernia containing a perforated sigmoid adenocarcinoma (which was confirmed by histopathology). The possibility of an irreducible inguinal hernia in association with perforated sigmoid colon cancer should be considered in the array of diagnoses. A pre-operative CT scan would be helpful in facilitating an accurate diagnosis.
Adenocarcinoma/complications/*radiography/surgery
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Aged, 80 and over
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Colon, Sigmoid/radiography/surgery
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Diagnosis, Differential
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Fatal Outcome
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Fever/etiology
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Hernia, Inguinal/complications/*radiography/surgery
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Humans
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Intestinal Perforation/complications/*radiography/surgery
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Male
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Pain/etiology
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Shock, Septic/complications
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Sigmoid Neoplasms/complications/*radiography/surgery
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Tomography, X-Ray Computed