Internal Supravesical Hernia as a Rare Cause of Intestinal Obstruction
Internal Supravesical Hernia as a Rare Cause of Intestinal Obstruction
Introduction: Supravesical hernias develop at the supravesical fossa between the remnants of the urachus and the left or right umbilical artery. They are often the cause of intestinal obstruction. We describe the anatomical variant of the supravesical hernia in this case and discuss the pre-operative findings revealed by computed tomography. We discuss diagnostic and therapeutic procedures, and review other anatomical variants.
Case presentation: A 60-year-old Senegalese man was admitted with a two-day history of small bowel obstruction. A physical examination showed abdominal distension. An abdominal X-ray revealed dilated small bowel loops. A computed tomography scan showed an image at the left iliac fossa that suggested an intussusception. A median laparotomy showed a left lateral internal supravesical hernia. The hernia was reduced and the defect was closed. The patient recovered uneventfully.
Conclusions: Supravesical hernia is a possible cause of intestinal obstruction and diagnosis is very often made intraoperatively. Morphological examinations, such as computed tomography scanning, can lead to a preoperative diagnosis. Laparoscopy may be useful for diagnosis and therapy.
Supravesical hernias develop at the supravesical fossa between the remnants of the urachus and the left or right umbilical artery. They have many anatomical variants and are often the cause of intestinal obstruction. A preoperative diagnosis is unusual despite the use of investigations such as computed tomography (CT). We report a case of a left lateral supravesical variety revealed by intestinal obstruction. We review the anatomical variants of supravesical hernias and discuss the diagnostic and therapeutic procedures involved in their management.
Abstract and Introduction
Abstract
Introduction: Supravesical hernias develop at the supravesical fossa between the remnants of the urachus and the left or right umbilical artery. They are often the cause of intestinal obstruction. We describe the anatomical variant of the supravesical hernia in this case and discuss the pre-operative findings revealed by computed tomography. We discuss diagnostic and therapeutic procedures, and review other anatomical variants.
Case presentation: A 60-year-old Senegalese man was admitted with a two-day history of small bowel obstruction. A physical examination showed abdominal distension. An abdominal X-ray revealed dilated small bowel loops. A computed tomography scan showed an image at the left iliac fossa that suggested an intussusception. A median laparotomy showed a left lateral internal supravesical hernia. The hernia was reduced and the defect was closed. The patient recovered uneventfully.
Conclusions: Supravesical hernia is a possible cause of intestinal obstruction and diagnosis is very often made intraoperatively. Morphological examinations, such as computed tomography scanning, can lead to a preoperative diagnosis. Laparoscopy may be useful for diagnosis and therapy.
Introduction
Supravesical hernias develop at the supravesical fossa between the remnants of the urachus and the left or right umbilical artery. They have many anatomical variants and are often the cause of intestinal obstruction. A preoperative diagnosis is unusual despite the use of investigations such as computed tomography (CT). We report a case of a left lateral supravesical variety revealed by intestinal obstruction. We review the anatomical variants of supravesical hernias and discuss the diagnostic and therapeutic procedures involved in their management.
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