Incarcerated transmesenteric hernia following appendectomy in Pediatric patient: case report

บทคัดย่อ

          Transmesenteric hernia is a rare cause of bowel obstruction. It can be strangulation and sepsis following obstruction and delay diagnosis. There are so many causes of transmesenteric hernia, more commonly described in postoperative patients, blunt abdominal trauma, inflammatory disease and less likely congenital.
          We present a case of transmesenteric hernia with incarcerated and strangulation of small bowel in 11-year old girl. She had previous surgery from appendicitis 1 month ago. This admission she had treat as severe gastritis and supportive treatment for 1 night and her symptom get worse and become early sign of sepsis. Investigation show she had transmesenteric hernia with bowel strangulation. Emergency laparotomy was performed. We found small bowel ischemia from herniation through ileum mesentery from adhesion of ileum to abdominal wall. We resection ischemia segment of ileum and anastomosis and lysis adhesion to prevent another attack of gut obstruction.