Congenital Treves’ field transmesenteric hernia in 7-month-old infant: A case report

IF 0.2 Q4 PEDIATRICS
Abdelrahman S. Elnour , Omer Abuagla , Faisal Nugud , Osman Taha
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Abstract

Introduction

Congenital Treves’ field hernia is the herniation of a visceral segment through a defect in the terminal ileal mesentery, poses a high risk of strangulation and bowel gangrene. Its preoperative diagnosis is challenging due to its rarity, nonspecific presentation, and often inconclusive imaging.

Case presentation

A previously healthy 7-month-old female infant presented with an 18-h history of intense diffuse abdominal pain, nausea, and bilious vomiting. On examination, she appeared ill and dehydrated, with tachycardia and tachypnea. Her abdomen was grossly distended, tense, and tender, with no visible scars or hernias. Blood tests, including a complete blood count, urea, and electrolytes, were normal except for an elevated white blood cell count. Abdominal X-rays and ultrasound revealed features consistent with distal small bowel obstruction, with no evidence of intussusception. Following resuscitation, an emergency laparotomy was performed for suspected acute abdomen due to distal small bowel obstruction. Intraoperatively, the jejunum and proximal ileum were dilated, and a portion of the ilium was found herniated through a 6 × 4 cm mesenteric defect. After reduction, approximately 25 cm of necrotic small bowel was resected, followed by an end-to-end anastomosis. The postoperative recovery was smooth, and she was discharged on day seven with no signs of short bowel syndrome on follow-up.

Conclusion

Congenital Treves’ field transmesenteric hernia is a rare cause of intestinal obstruction in children that should be considered in cases of mechanical small bowel obstruction.
7 个月大婴儿的先天性特雷韦斯野外跨肠管疝:病例报告
导言先天性特雷韦氏野疝是指内脏部分通过回肠系膜末端的缺损疝出,极易造成绞窄和肠坏疽。由于其罕见性、非特异性表现和通常不确定的影像学表现,其术前诊断极具挑战性。病例介绍 一名 7 个月大的健康女婴因强烈的弥漫性腹痛、恶心和胆汁性呕吐就诊 18 小时。经检查,她看起来不适且脱水,伴有心动过速和呼吸急促。她的腹部明显胀大、紧张和压痛,没有明显的疤痕或疝气。除了白细胞计数升高外,包括全血细胞计数、尿素和电解质在内的血液化验结果均正常。腹部 X 光片和超声波检查显示与远端小肠梗阻一致,但没有肠套叠的迹象。经过抢救,因怀疑是远端小肠梗阻导致的急腹症,医生为其实施了急诊开腹手术。术中,空肠和回肠近端扩张,发现部分髂骨通过一个 6 × 4 厘米的肠系膜缺损疝出。在缩小手术范围后,切除了约 25 厘米的坏死小肠,随后进行了端对端吻合术。结论先天性特雷韦斯氏野跨肠系膜疝是导致儿童肠梗阻的罕见原因,在机械性小肠梗阻的病例中应加以考虑。
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来源期刊
CiteScore
0.60
自引率
25.00%
发文量
348
审稿时长
15 days
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