FEATURES OF THE CLINIC AND DIAGNOSTICS OF TRANSMESOSIGMOID HERNIA

Abstract

A clinical case is presented that reflects the difficulties in diagnosing a restrained transm esosigm oid hernia, as w ell as m odern literature data on transm esosigm oid hernias. In patients w ith no history o f abdom inal surgery or peritoneal inflam m ation, but the presence o f progressive or persistent sym ptom s o f sm all bow el obstruction, atransm esosigm oid hernia should be kept in m ind in the differential diagnosis process. In differential diagnosis, it is first n ecessary to consider such m ore frequent causes of small bowel obstruction, such as postoperative adhesions, hernias o f the abdom inal wall and tumors. Once these conditions have been ruled out, a high index o f suspicion for transm esosigm oid hernia should be m aintained. It is assum ed that the diam eter of the opening o f a transm esosigm oid hernia, causing sm all bow el obstruction, is usually 2-5 cm. Regular re-assessm ent of the condition of patients receiving conservative treatm ent is mandatory for the tim ely recognition of intestinal ischem ia. When indicated, it is necessary to perform surgical intervention.