Internal hernias: unusual causes of small bowel obstruction, about 11 cases

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\n\tInternal hernias are rare and develop when one or more viscera protrude through an intraperitoneal orifice while remaining within the peritoneal cavity. The clinical diagnosis is always difficult and leads to an urgent operation for intestinal obstruction. The treatment is often simple and the results are generally excellent [1]. In the literature, some case reports have been described, but rarely series [1,2]. The aim of our study is to report 11 cases of internal hernia representing different anatomical types of the 11 cases presently reported, the sex ratio showed a male prevalence with a mean age of 39 years. Symptomatology was totally non specific and the preoperative diagnosis was possible only for tow cases by scan imaging. \n \n\t \n \n\tAll patients were explored urgently: 7 were hernias through a paranormal orifice (3 left and 2 right par duodenal, 1 intra-mesosigmoidal and 1 retrocecal), 4 were hernias through a pathologic orifice: 2 trans-mesenteric, 1 in the posterior cavity through a colo-omental dissinsertion hole and 1 trans-mental. Reduction of herniated viscera was simple, by gentle traction for nine patients, but requiring dilatation of the hernial orifice with resection of the ischemic small bowel in 2 cases. So, internal hernias remain a rare cause of consultation on emergency. It must be evocated in patients with no medical history and consulting for acute intestinal obstruction. The CT scan suggests often the diagnosis that is confirmed at surgical exploration. The treatment is always surgery.

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