Le Duc Nam, Thai Khac Trong, Nguyen Van Thach, Le Duy Dung, Lam Sao Mai, Tong Thi Thu Hang
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引用次数: 0
Abstract
Introduction: A transverse mesocolic internal hernia is a phenomenon in which a small intestinal loop protrudes through the natural orifice in the transverse colon mesentery. This type of internal hernia in adults, although rare, is one of the causes of closed-loop intestinal obstruction, which requires prompt diagnosis and treatment.
Case presentation: We report two cases of transverse mesocolic internal hernia that were examined and subsequently treated at Hospital 108, Hanoi, Vietnam. Both patients (53 and 66 years old) had atypical clinical symptoms, mainly dull epigastric pain. Upon admission, they were initially examined clinically, followed by blood testing and chest and abdominal X-ray radiography. Diagnostic imaging was mainly based on subsequent Multidetector-Row Computed Tomography (MDCT). Laparoscopic/surgical release of the hernia and closure of the natural orifice in the transverse colon mesentery were performed. The clinical symptoms and laboratory and radiographic findings did not suggest a causal diagnosis. However, MDCT provided several images suggestive of an internal hernia, including a closed intestinal loop passing through the transverse colon mesentery and located posteriorly in the left abdominal cavity near the Treitz angle, displacement of the mesenteric vascular bundle, and colon displacement. These displacements were the causes of intestinal inflammation/obstruction. Additionally, laparoscopic/surgical results confirmed the MDCT diagnosis.
Conclusion: Thin-slice thickness, high spatial resolution, multiplanar reconstruction MDCT was effective for diagnosing transverse mesocolic internal hernia. In our two cases, MDCT helped determine the cause and assess the state of intestinal ischemia.
期刊介绍:
Current Medical Imaging Reviews publishes frontier review articles, original research articles, drug clinical trial studies and guest edited thematic issues on all the latest advances on medical imaging dedicated to clinical research. All relevant areas are covered by the journal, including advances in the diagnosis, instrumentation and therapeutic applications related to all modern medical imaging techniques.
The journal is essential reading for all clinicians and researchers involved in medical imaging and diagnosis.