Internal hernia through a mesoappendiceal defect causing gangrenous small bowel obstruction and gangrenous appendix: a case report and literature overview
Year: 2026
Type: article
Study design: Case Report
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.
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,090
OpenAlex ID: W7225733247