Computed tomography imaging features of bowel obstruction caused by internal hernia: A retrospective study of 29 cases
Year: 2026
Type: article
Study design: Observational Study
Abstract: Introduction Internal hernia (IH) is a rare but significant cause of small bowel obstruction (SBO), often associated with high risk of strangulation and bowel ischemia. Due to nonspecific clinical manifestations, early and accurate diagnosis remains challenging. Multidetector computed tomography (CT) has emerged as the preferred imaging modality, offering detailed visualization of bowel loops and mesenteric vasculature. Methods This retrospective study included 29 patients diagnosed with internal hernia–related SBO at two tertiary hospitals in Ho Chi Minh City between January 2018 and March 2023. All patients underwent contrast-enhanced abdominal CT prior to surgery. Imaging features were independently assessed by two radiologists and compared with intraoperative findings to evaluate diagnostic performance and subtype classification. Results The most frequently encountered hernia subtype was transmesenteric (45%), followed by pericecal and sigmoid-related hernias (17% each). CT successfully identified internal hernias in 65.5% of cases and correctly classified the subtype in 37.9%. Key imaging features included clustered small bowel loops (65.5%), mesenteric vessel abnormalities (65.5%), and displacement of adjacent organs (65.5%). CT signs suggestive of ischemia, such as bowel wall thickening, fat stranding, and abnormal enhancement, were significantly associated with surgical confirmation of ischemia ( P < 0.05). Conclusion CT imaging plays a critical role in the diagnosis and management of internal hernias causing small bowel obstruction. While accurate subtype identification remains difficult, awareness of characteristic CT features can facilitate earlier diagnosis and intervention, potentially reducing morbidity from delayed treatment.
Source: Imaging
Authors: Anh Quynh Dang, Phi Duong Nguyen
Institution: Vinmec Nha Trang Hospital
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7148546183