Internal hernia

Contributors: Cafer Zorkun M.D., PhD.

Overview

 * Protrusion of the viscera through the peritoneum or mesentery and into a compartment in the abdominal cavity.
 * Most common presentation is an acute intestinal obstruction of small bowel loops that develops through normal or abnormal apertures.
 * Responsible hernial orifices are usually preexisting anatomic structures, such as foramina, recesses, and fossae.
 * Pathologic defects of the mesentery and visceral peritoneum, which are caused by congenital mechanisms, surgery, trauma, inflammation, and circulation, are also potential herniation orifices.

Types of internal hernias

 * Foramen of Winslow
 * Paraduodenal
 * Transmesenteric
 * Transomental
 * Pericecal
 * Sigmoid mesocolon
 * Supravesical
 * Pelvic hernias

Computed Tomography

 * Encapsulation of distended bowel loops with an abnormal location, arrangement or crowding of small-bowel loops within the hernial sac, evidence of obstruction with segmental dilatation and stasis.
 * Mesenteric vessel abnormalities, with engorgement, crowding, twisting, and stretching of these vessels

'''Patient #1: Patient presents with intermittent abdominal pain. The patient had a history of gastric bypass'''

Images courtesy of RadsWiki