Clinical spectrum of internal hernia: A surgical emergency

Hsiu Ping Fan, Albert D. Yang, Yu Jun Chang, Chi Wen Juan, Han Ping Wu*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

46 Scopus citations

Abstract

Purpose. To define the indicators of bowel ischemia caused by congenital or acquired internal hernia, based on our 10-year experience in one center. Methods. We reviewed the medical records, imaging studies, and operative findings of 20 patients who underwent surgery for an internal hernia at our medical center between 1995 and 2005. The clinical characteristics and related indicators of the patients with, and those without bowel ischemia were compared and analyzed statistically. Results. The subtypes of congenital internal hernia (CIH) included transmesenteric (n = 6, 60%), paraduodenal (n = 2, 20%), and pericecal (n = 2, 20%) hernia. The abdominal surgical procedures preceding acquired internal hernia (AIH) were Roux-en-Y anastomosis (n = 6, 60%) and appendectomy (n = 3, 30%). Transmesenteric hernia was the most prevalent type of CIH in children. Abdominal rebound tenderness, advanced leukocytosis (>18 000/mm3), or a high level of manual band form (>6%) were the positive predictive factors for bowel ischemia, whereas a history of chronic intermittent abdominal pain was a negative indicator. No recurrence was noted during the 10-year study period. The overall mortality rate was 20%, attributable to enteral bacteria sepsis in all cases. Conclusion. Internal hernia is a rare but lethal condition. Early diagnosis and prompt surgical intervention provide the only chance of a successful outcome.

Original languageEnglish
Pages (from-to)899-904
Number of pages6
JournalSurgery Today
Volume38
Issue number10
DOIs
StatePublished - 10 2008
Externally publishedYes

Keywords

  • Bowel ischemia
  • Indicator
  • Internal hernia
  • Small-bowel obstruction

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