부산대학교 도서관

An 87-year-old woman was admitted to our hospital with abdominal pain, nausea and vomiting. An abdominal radiography showed intestinal obstruction with niveau formation, and CT scan revealed a closed loop of the small intestine in the vicinity of ileocecum. We diagnosed ileus due to internal hernia. Initially, conservative therapy with an ileus tube was performed. Since improvement of the obstruction was not achieved and we conducted an operation on the ninth hospital day. The laparotomy revealed that the ileum was incarcerated 50 cm proximal from the terminal ileum into a posterior mesenteric defect of the terminal ileum. On a diagnosis small intestinal inamesenteric hernia we reduced the incarceration and closed the defect. No intestinal resection was required. The patient improved and was discharged from hospital on the 13th postoperative day. The occurrence of the small intestinal inamesenteric hernia is uncommon and only 4 cases, including ours, have been reported in the Japanese literature from 1983. We report this case and discuss the cases of the small intestinal inamesenteric hernia previously reported in Japan.