https://doi.org/10.1016/J.IJSCR.2025.111314
Traumatic transmesenteric hernia (TTMH) is an exceptionally rare but potentially life-threatening condition that can occur after blunt abdominal trauma, often leading to complications like ischemic enterocolitis. A 13-year-old girl with a history of a fall developed acute abdominal pain, bilious vomiting, and hypovolemic shock. Imaging raised suspicion of intestinal obstruction, and an emergency laparotomy revealed a transmesenteric hernia with ischemic ileum. The patient underwent bowel resection and ileostomy, followed by a successful reversal. Diagnosis of TTMH is challenging and often occurs during emergency surgery. This case underscores the importance of a high index of suspicion for trauma patients presenting with acute abdomen, as early intervention is crucial to avoid morbidity and mortality. Awareness and follow-up are key for trauma patients at risk for internal hernias.
For further details on diagnosis, management, and outcomes, read the full case report here:
https://doi.org/10.1016/J.IJSCR.2025.111314
Keywords: #TransmesentericHernia #Trauma #EmergencyMedicine #CaseReport #IschemicEnterocolitis #Ileostomy #AbdominalTrauma #InternalHernia
- @Alaa Badr Habeebullah Yes indeed possible, which we have presented in this case report. But to our wonder we found that only one case report existed in current literature before. Thus we should advocate more about it to make it integrated into our clinical practice which is a rare instant but still possible. I hope you will find the case interesting.
Trauma is an established but rare cause of transmesenteric hernia, as described in research articles on the subject. However, in more than 40 years of surgical practice, I have not encountered such clinical cases in adults.
@Igro Kryovurochko Exactly! It's possible in pediatric patients as far reported in existing literature - nice notice.
Yes, trauma can cause transmesenteric hernias.
Evidence mainly stems from a few case reports demonstrating:
Direct trauma causing mesenteric tears that lead to internal herniation.
Trauma precipitating herniation in pre-existing anatomical weaknesses.
While extremely rare, these reports underscore the importance of considering traumatic transmesenteric hernia in acute surgical assessments of abdominal trauma with obstruction or ischemia.
I have only seen 1 case of traumatic hernia in blunt abdominal trauma that was resolved by minimally invasive surgery with a favourable outcome for the patient.
Yes, is a possibility with mesenteric injury. . This situation one must look for bowel ischemia.
Mauricio Zuluaga Aswini Kumar Pujahari Very good insights from your personal experience! This was once in a lifetime case I thought I found 2nd time after searching literature. Now I can understand it's actually under represented & demands clear guidelines to treat such patient in low resource setting like Bangladesh. Please have a read : Article Traumatic transmesenteric hernia leading to ischemic enteroc...
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