Small intestinal perforations due to acquired internal herniation

Abstract

AimAn internal hernia is a very rare cause of acute small bowel obstruction and perforation which may be difficult to diagnose. We aimed to provide a retro-spective study for management and evaluated patients who underwent surgery for perforation due to intestinal internal herniation in our department.MethodsFrom January 2012 to April 2017, seven patients underwent surgery for a perforation due to intestinal internal herniation at our clinic. We retro-spectively reviewed the patients’ records, imaging modalities, and operative findings.ResultsThere were two women and five men with a mean age of 52.50 ± 11.22 years. All patients were admitted to our emergency surgery unit with the complaints of acute abdominal pain, distension, and fever. All patients were urgently operated. The mean hospital stay was 5.50 ± 1.37 days. In the postoperative period, two patients had wound infection, and postoperative mortality was not observed.ConclusionPerforation due to an internal hernia occur because of the delayed diagnosis of the internal hernia. Unfortunately, they have bad outcomes. They usually rapidly progress to bowel ischemia once strangulated and have no definitive predictors. At surgery, complete closure of the potential defects that may predispose to an internal hernia is essential for prevention. Especially in patients who had previous abdominal surgery, internal hernia should be kept in mind to prevent delay in diagnosis.

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