A Rare Internal Herniation in Adult: Meckel's Diverticulum.

Intestinal obstruction due to Meckel's diverticulum is the most common presentation in adults. There are various mechanisms by which it can cause intestinal obstruction such as volvulus of small intestine around a fibrous band extending from Meckel's diverticulum to umbilicus, intussusception, and Littre's hernia. We report the case of a young adult operated on emergency for acute intestinal obstruction. The CT scan suggested a nonspecific internal herniation. Surgical exploration confirmed a rare type of obstruction due to Meckel's diverticulum.

Adult intussusception caused by an inflammatory fibroid ileal polyp.

BACKGROUND: Inflammatory fibroid polyps (IFPs) are rare benign lesions of uncertain origin that may occur in various parts of the gastrointestinal tract that originate from the sub mucosa located in different sites of the digestive tract. They are commonly located in the stomach and small bowel. It is one of the probable diagnoses that should be considered in obstructive tumors of the small intestine causing invagination. METHODS: A case of IFP is presented, causing intestinal invagination in an 39-year-old female patient, admitted with abdominal distension and pain. RESULT: Computerised tomography imaging (CT) demonstrated intussusception of the small bowel. Exploratory laparotomy revealed a bowel intussusception. An ileo-ileal anastomosis was performed after resection of the tumoral segment. Histology of the resected small bowel revealed an inflammatory fibroid polyp. CONCLUSIONS: intussusception secondary to IFPs of the small intestine are difficult to diagnose without recognition of its clinical and pathological characteristics. CT is useful in confirming an anatomical abnormality, histological examination establishes the final diagnosis of IFPs.

Mesenteric appendicitis strangulating small bowel: an exceptional internal herniation.

Primitive internal hernias are a rare cause of intestinal obstruction. They are often paraduodenal even transmesocolic, but only rarely transomental. We present a rare case of an internal abdominal hernia in a young man. The small bowel was strangulated by an intra mesenteric appendicitis. This hernia was revealed by abdominal pain, nausea and vomiting. Plain X-ray of the abdomen showed dilated jejunal and ileal loops with multiple air-fluid levels. The diagnosis of appendicitis was suggested by ultrasound but the internal hernia was found only upon surgical exploration. An appendicectomy and adhesiolysis were performed. The patient recovered fully after 3 days, and had an uneventful postoperative course. The authors discuss the possible cause of this rare intestinal obstruction.

[Biliary ileus: diagnostic and therapeutic aspects. Report of a case]. / L'iléus biliaire : réflexions diagnostiques et thérapeutiques. A propos d'une observation.

We report a rare case of small bowel gallstone obstruction in a patient with cholecystointestinal fistula. Diagnosis of this condition is usually difficult and only achieved at surgery. We review the radiological findings, particularly the CT findings, helpful for diagnosis: ectopic gallstone, biliary gas and fistula. Early preoperative diagnosis could reduce morbidity and mortality. Treatment is surgical with enterolithotomy. There is some controversy over the need to repair the fistula.

Transmesocolic internal herniation: a rare case of small bowel obstruction, "the Marrakesh hernia".

Internal hernias, including paraduodenal (traditionally the most common), pericecal, foramen of Winslow, and intersigmoid hernias, account for approximately 0.5-5.8% of all cases of intestinal obstruction and are associated with a high mortality rate, exceeding 50% in some series. We report an extremely rare case of an internal abdominal hernia, through the right mesocolon, in a young woman with a right colon with no peritoneal fixation. This hernia was revealing by abdominal pain, nausea, and vomiting. The diagnosis of internal hernia was suggested by computed tomography (CT), but the exact type of internal hernia was confirmed by surgical exploration. The postoperative course was uneventful and the patient fully recovered after 3 days. The patient is free from symptoms and from recurrence, after 12 months of follow-up.

[Sigmoid volvulus, a rare complication of pregnancy]. / Volvulus du sigmoïde, une complication rare de la grossesse.

Sigmoid volvulus complicating pregnancy is a rare complication with less than 80 cases reported in literature. We report the case of a young pregnant woman, admitted for sigmoid volvulus. The sigmoid volvulus was resected and Bouilly-Volkmann's colostomy was performed. According to this case and depending on the literature, the authors discuss the diagnostic and therapeutic modalities proposed for this rare entity.