Internal hernia through mesoappendix causing small bowel obstruction: A case report

Introduction: Intestinal obstruction is one of causes of acute abdomen leading to laparotomy. Even though there are different causes of small bowel obstruction (SBO), internal hernia is a rare one. Though different types of internal hernias occur, herniation through the mesoappendix is reported only four times in the literature. Case presentation: We describe here such a type of hernia on a 50 yrs old male presented with symptoms and signs of SBO whose cause was diagnosed to be internal hernia through mesoappendix intraoperatively. He was managed with appendectomy and release of the hernia. Clinical discussion: Intestinal obstruction is a common cause of acute abdominal conditions and can lead to significant mortality if not managed appropriately. Internal hernias account for less than 1 % of intestinal obstruction cases. The cause of trans-mesoappendicular internal hernias remains largely unknown. A congenital defect in the mesoappendix may contribute to the development of these hernias. Conclusion: In patients with acute intestinal obstruction without previous surgery, internal hernia should be considered as a differential diagnosis. Trans-mesoappendicular hernia is extremely rare type of internal hernia.