Transmesenteric internal hernia


This is a case of a transmesenteric internal hernia.

There is no strangulation at present.

Signs of strangulation include: bowel wall thickening in side the hernial sac, lack of SMV enhancement, fluid in the hernial sac and fat stranding in the herniated bowel mesentery.

There is no malrotation.

Internal hernias can be overlooked if the large bowel is not traced carefully.

A useful sign to alert the radiologist to a possible internal hernia, is seeing the cecum abnormally positioned, with the additional clue of seeing the small bowel surrounding the outside the large bowel (as illustrated).

There is no history of previous surgery to account for the mesenteric defect.