Asian Journal of Research in Surgery

Strangulated Pericecal Internal Hernia –Two Case Reports

S. N. Jatal *

Jatal Hospital and Research Centre, Latur, India.

Sudhir Jatal

Jatal Hospital and Research Centre, Latur, India.

Supriya Jatal

MGM Hospital & College, Navi Mumbai, India.

*Author to whom correspondence should be addressed.

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Abstract

A Pericecal hernia is a relatively uncommon form of internal hernia, accounting for only 6-13% of all cases of abdominal internal hernias. It presents with clinical symptoms that closely resemble appendicitis, often causing severe lower abdominal pain and potential complications. This type of hernia occurs due to a defect in the mesentery of the cecum, which can be either congenital or acquired. The most prevalent subtype of Pericecal hernia is the retrocecal hernia, where ileal loops herniate through a defect in the cecal mesentery and the right paracolic gutter. These hernias typically develop within one of four peritoneal fossae: the superior ileo-cecal, inferior ileo-cecal, retro-cecal, and paracolic sulci. Pericecal hernias are also referred to as ileo-colic, retrocecal, ileocecal, or paracecal hernias.

Diagnosis of a Pericecal hernia is often made through abdominal CT scans, which reveal a cluster of bowel loops, typically ileal, located posteriorly and laterally to the normal cecum, extending into the right paracolic gutter. These hernias can lead to small bowel obstruction and displace the cecum anteriorly and medially. Early diagnosis and surgical intervention are crucial to prevent complications.

We present two cases of Pericecal internal hernia: one involving a 9-year-old boy and the other a 35-year-old male patient. Both patients exhibited symptoms of small bowel obstruction. Abdominal CT scans confirmed the presence of a Pericecal hernia with a strangulated small bowel. Exploratory laparotomy revealed the strangulated Pericecal hernia, which was successfully treated through manual hernia reduction and repair of the mesenteric defect.

Keywords: Pericecal hernia, paracecal hernia, internal hernia, cecum

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References

Svetlana Kleyman, Shafia Ashraf, Sherin Daniel, Dinesh Ananthan, Aliu Sanni, Feroze Khan, Pericecal hernia: a rare form of internal hernias, Journal of Surgical Case Reports. February 2013; 2013(2):rjs021. DOI: https://doi.org/10.1093/jscr/rjs021

Kang SI. Incarcerated pericecal hernia: a rare form of the internal hernia. Yeungnam Univ J Med. 2018 Dec;35(2): 236-239. DOI:10.12701/yujm.2018.35.2.236. Epub 2018 Dec 31. PMID: 31620601; PMCID: PMC6784704.

Masaaki Shida, Masayuki Tanaka, Toshiya Tanaka, Yoshihiko Kitajima, Seiji Sato, Successful Retrocecal Hernia Diagnosis and Treatment: A Case Report, Int Surg 2021;105:469–473 DOI: 10.9738/INTSURG-D-16-00187.1

Yokota T, Otani K, Yoshida J et al. Paracecal hernia due to membranous adhesion of the omentum to the right paracolic gutter. Surg Case Rep. 2019;5: 183. DOI:https://doi.org/10.1186/s40792-019-0749-8

Ogami T, Honjo H, Kusanagi H. Pericecal hernia manifesting as a small bowel obstruction successfully treated with laparoscopic surgery. J Surg Case Rep. 2016 Mar 1;2016(3):rjw020 DOI:10.1093/jscr/rjw020 PMID: 26933000 PMCID: PMC4772000.

Bensaad A, Habi J, El Aidaoui K, et al. A Fatal Case of Strangulated Pericecal Hernia. Cureus July 01, 2021;13(7): e16097. DOI:10.7759/cureus.16097

Doishita S, Takeshita T, Uchima Y, Kawasaki M, Shimono T, Yamashita A, et al. Internal hernias in the era of multidetector CT: correlation of imaging and surgical findings. Radiographics. 2016;36:88-10

Anand M, Sahi PK. Pericecal hernia: An unusual cause of abdominal pain in a child. Indian Pediatr Case Rep [serial online] [cited 2023 Sep 18] 2021;1:43-6. Available:http://www.ipcares.org/text.asp?2021/1/1/43/310210

Seretis C, Katz C, Ahmed A, Palit A, Piramanayagam B, Marimuthu K. Pericecal fossa strangulated internal hernia. Clin Case Rep. 202;9:2469–2470. DOI:https://doi.org/10.1002/ccr3.3917

Jang EJ, Cho SH, Kim DD. A case of small bowel obstruction due to a paracecal hernia. J Korean Soc Coloproctol. 2011;27:41–3. [PMC free article] [PubMed] [Google Scholar]