Internal hernia due to mesenteric defect
An 18-year-old woman was brought to our emergency department with sudden onset lower abdominal pain. She had no remarkable past medical history and took no medications.\nOn physical examination, her abdomen was firm and an ∼15 cm fullness was palpable in the mid-to-lower abdomen, with severe tenderness.\nAbdominal computed tomography (CT) revealed loops of edematous small intestines which possible gangrenous changes ().\nAn emergency laparotomy was performed. On exploring the abdominal cavity, small intestine was necrotic. The mesenteric defect is detected in the jejunal region, 3 cm in size (Fig. ). Loops of small intestine had gone through the defect three times in a complex manner and strangulated. The mesenterium needed to be incised to complete resection of necrotic small intestines. The gangrenous intestines were resected and a primary anastomosis was performed.\nThe patient's postoperative course was uneventful and she was discharged on postoperative day 6 without any complications.