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Internal Hernias: Clinical Findings, Management, and Outcomes in 49 Nonbariatric Cases

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Internal hernia, the protrusion of a viscus through a peritoneal or mesenteric aperture, is a rare cause of small bowel obstruction. We report the clinical presentation, surgical management, and outcomes of one of the largest series of nonbariatric internal hernias. Ten-year retrospective review of patients at our institution yielded 49 cases of internal hernias. Majority of patients presented with symptoms of acute (75%) or intermittent (22%) small bowel obstruction. While 16% of CT scans were suspicious for internal hernia, in no cases the preoperative diagnosis of internal hernia was made. The most frequent internal hernias were transmesenteric (57.0%) and 34 hernias (69%) were caused by previous surgery. All internal hernias were reduced and the defects were repaired. Compromised bowel was present in 22 cases and 11 patients underwent small bowel resection. The mean postoperative hospitalization was 10.9 days. The overall mortality rate from our series is 2%, and the morbidity rate is 12%. Transmesenteric hernias, as complications of previous surgeries, are the most prevalent internal hernias. Preoperative diagnosis of internal hernia is extremely difficult because of the nonspecific clinical presentation. However, if discovered promptly, internal hernias can be repaired with acceptable morbidity and mortality.

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Authors and Affiliations

  1. Department of Surgery, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1259, New York, NY, 10029, USA

    Saber Ghiassi, Scott Q. Nguyen, Celia M. Divino, John C. Byrn & Avraham Schlager

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  1. Saber Ghiassi
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  2. Scott Q. Nguyen
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  3. Celia M. Divino
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  4. John C. Byrn
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  5. Avraham Schlager
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Correspondence to Celia M. Divino.

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Ghiassi, S., Nguyen, S.Q., Divino, C.M. et al. Internal Hernias: Clinical Findings, Management, and Outcomes in 49 Nonbariatric Cases. J Gastrointest Surg 11, 291–295 (2007). https://doi.org/10.1007/s11605-007-0086-2

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