UNUSUAL CASE OF TRANSMESOCOLIC HERNIA CONTAINING A MESENTERIC TUMOR

Patricia Monalisa Paraschiva1, O. Ştefan1, Ș.R. Vagner 1, S. Stănilescu2, T. Burcoș1,2, D. Cristian1,2
1The University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania
2”Colțea” Clinical Hospital, The Surgery Department, Bucharest, Romania
Corresponding author: Patricia Monalisa Paraschiva
Phone no. 0040730610975
E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

Abstract

Internal hernias (IH) have an incidence of less than 1% and they account for approximately 0,5- 5,8% of all cases of small bowel obstruction. Transmesocolic hernia (TH) is a particularly type of IH, more likely to develop complications that can be life threatening. Mesenteric cysts are rare benign intra-abdominal tumors, most commonly seen in the ileal mesentery, with an incidence <1/100,000. These conditions are usually discovered accidentally during investigations for other disorders and may be sometimes misdiagnosed. We present a case of an extremely rare transmesocolic hernia containing a mesenteric tumor, discovered incidentally in the course of screening for metastasis in a breast cancer, for which she previously underwent surgery. The patient had no symptoms, no signs on physical examination and no history of abdominal surgery. The imagistic explorations were highly suggestive for a transmesocolic hernia and a supramesocolic cyst of unknown origin. The patient underwent laparotomy in order to ascertain the diagnosis and to choose the most suitable surgical approach and it revealed a transmesocolic hernia with a mesenteric tumor at the site of herniated mesentery. After surgical treatment was provided, the histopathology report confirmed the diagnosis of mesenteric cyst. The post-operative period was uneventful and the patient follow-up showed no reccurence. In order to prevent complications, surgeons must be aware of the existence of this type of hernia, even when the patient is asymptomatic and has no history of abdominal surgery.

Keywords: internal hernia, transmesocolic hernia, mesenteric cyst

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