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Case Reports in Surgery
Volume 2016, Article ID 3540794, 3 pages
Case Report

A Rare Type of Primary Internal Hernia Causing Small Intestinal Obstruction

1Department of General Surgery, Shri Ramachandra Bhanj (S.C.B.) Medical College, Cuttack, Odisha 753007, India
2Department of Obstetrics & Gynaecology, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha 751019, India

Received 31 July 2016; Accepted 7 November 2016

Academic Editor: Mehrdad Nikfarjam

Copyright © 2016 Sibabrata Kar et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Primary internal hernias are extremely rare in adults. They are an important cause of small intestinal obstruction and lead to high morbidity and mortality if left untreated. Clinical presentation of internal hernia is nonspecific. Imaging has been of limited utility in cases of acute intestinal obstruction; moreover, interpretation of imaging features is operator dependant. Thus, internal hernias are usually detected at laparotomy and preoperative diagnosis in an emergency setting is either difficult or most of the time not suspected. We report herein a case of a 45-year-old male who presented with acute intestinal obstruction which was attributed later to a very rare type of internal hernia on exploratory laparotomy. A loop of ileum was found to enter the retroperitoneum through a hernia gate which was located lateral to the sigmoid colon in the left paracolic gutter. The segment of intestine was reduced and the hernial defect was closed. Our finding represents an extremely rare variant of retroperitoneal hernias.