Internal hernias are rare but they carry a great risk of strangulation:
Ä Aetiology. They may occur through defects in the mesentery or omentum caused by surgical interference, or they develop in the natural peritoneal recesses, i.e. the lesser sac. the duodenal fossae, the caecal fossae and intersigmoid fossa.
Ä Diagnosis. They produce the signs of intestinal obstruction and are only discovered at operation.
Ä Treatment. Important vessels may be related to the neck of the peritoneal recess and great care must be taken not to injure them during reduction of the contents, e.g. the portal vein, common bile duct and hepatic artery are related to the opening of the lesser sac, the inferior mesenteric vein to the paraduodenal racess and the superior mesenteric artery to the mesenterico-parietal recess at the beginning of the jejunum.
SOURCE: DR. AYMAN SALEM'S BOOK
Copyright: Vascular Society of Egypt (www.vsegypt.org) &Medical Educational web (www.meduweb.com)
Not to be reproduced without permission of Vascular Society of Egypt