Internal hernia through a mesoappendiceal defect causing gangrenous small bowel obstruction and gangrenous appendix: a case report and literature overview
- 1Jinka General Hospital, Southern Ethiopia Regional Health Bureau, Jinka, Ethiopia
- 2Yejubie Primary Hospital, Amhara Regional Health Bureau, Bahrdar, Ethiopia
- 3Yirba Primary Hospital, Sidama Regional Health Bureau, Hawassa, Ethiopia
Abstract
Background:: An internal hernia is a cause of small-bowel obstruction and may lead to bowel ischemia and strangulation if not diagnosed early. Herniation through a defect in the mesoappendix is an exceptionally uncommon type of internal hernia, with only a few cases reported in the literature. Because the clinical presentation is nonspecific, preoperative diagnosis is difficult and most cases are identified during surgery.
Case presentation:: We report a case of a 42 years old female patient who presented with symptoms and signs of small bowel obstruction and generalized peritonitis, whose cause was diagnosed intraoperatively as an internal hernia through the mesoappendix. Intraoperative findings revealed a gangrenous segment of ileum herniated through a defect in the mesoappendix, and the distal shaft and tip of the appendix were also gangrenous. She was managed with en bloc resection, ileostomy, and appendectomy. Postoperative management included antibiotic therapy and wound care. The patient recovered uneventfully and was discharged home in stable condition.
Discussion:: Internal herniation through a mesoappendiceal defect is an extremely rare cause of small-bowel obstruction and poses a diagnostic challenge because its clinical presentation is nonspecific in most cases; definitive diagnosis is made intra-operatively. Surgical exploration remains critical for both diagnosis and management of this potentially life-threatening condition.
Conclusion:: Small-bowel obstruction secondary to internal herniation through a mesoappendiceal defect should be considered in the differential diagnosis of patients presenting with small-bowel obstruction.
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BibTeX
@article{woldekidan2026internal,
title = {{Internal hernia through a mesoappendiceal defect causing gangrenous small bowel obstruction and gangrenous appendix: a case report and literature overview}},
author = {Eyob Shiferaw Woldekidan and Sewnet Ejigu Mekonnen and Ermias Gebremeskel Gebreslassie and Natnael Abera Asrat and Fiseha Teshome Kebede},
journal = {International Journal of Surgery Case Reports},
year = {2026},
month = oct,
doi = {10.1097/rc9.0000000000001010},
url = {https://doi.org/10.1097/rc9.0000000000001010},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Internal hernia through a mesoappendiceal defect causing gangrenous small bowel obstruction and gangrenous appendix: a case report and literature overview
AU - Eyob Shiferaw Woldekidan
AU - Sewnet Ejigu Mekonnen
AU - Ermias Gebremeskel Gebreslassie
AU - Natnael Abera Asrat
AU - Fiseha Teshome Kebede
PY - 2026
DA - 2026/10/06
JO - International Journal of Surgery Case Reports
DO - 10.1097/rc9.0000000000001010
UR - https://doi.org/10.1097/rc9.0000000000001010
AB - Background:: An internal hernia is a cause of small-bowel obstruction and may lead to bowel ischemia and strangulation if not diagnosed early. Herniation through a defect in the mesoappendix is an exceptionally uncommon type of internal hernia, with only a few cases reported in the literature. Because the clinical presentation is nonspecific, preoperative diagnosis is difficult and most cases are identified during surgery. Case presentation:: We report a case of a 42 years old female patient who presented with symptoms and signs of small bowel obstruction and generalized peritonitis, whose cause was diagnosed intraoperatively as an internal hernia through the mesoappendix. Intraoperative findings revealed a gangrenous segment of ileum herniated through a defect in the mesoappendix, and the distal shaft and tip of the appendix were also gangrenous. She was managed with en bloc resection, ileostomy, and appendectomy. Postoperative management included antibiotic therapy and wound care. The patient recovered uneventfully and was discharged home in stable condition. Discussion:: Internal herniation through a mesoappendiceal defect is an extremely rare cause of small-bowel obstruction and poses a diagnostic challenge because its clinical presentation is nonspecific in most cases; definitive diagnosis is made intra-operatively. Surgical exploration remains critical for both diagnosis and management of this potentially life-threatening condition. Conclusion:: Small-bowel obstruction secondary to internal herniation through a mesoappendiceal defect should be considered in the differential diagnosis of patients presenting with small-bowel obstruction.
SN - 2210-2612
ER -