Trans Mesosigmoid Hernia


Eunice Fedora Francis, Sampath Kumar P., Rahul Raj C. L

A 34-year-old lady presented with sudden acute abdominal pain and vomiting. She showed no other symptoms except continuous vomiting and no flatus after onset. Patient gave a history of previous surgery for ectopic gestation 10 years back. On general examination, pulse rate was 60/min, and blood pressure was 110/70 mmHg. On per abdominal examination, there was a vague firm (fullness) swelling in the left iliac region and diffuse tenderness and sluggish bowel sound. Laboratory tests showed elevated white blood cells (WBC) count (21.7 × 103 /μl). Radiological investigation was suggestive of small bowel obstruction. In view of subacute intestinal obstruction, patient was conservatively managed with Ryle’s tube decompression and IV fluid and was serially monitored. Patient’s general condition was not improving; hence, with the diagnosis of small bowel obstruction we performed emergency exploratory laparotomy.