He had been more or less constipated as long as he could remember and had used cathartics for the past 30 years. The pain would be relieved by lying on the right side. This had increased in severity during the past six years. He stated that for 25 years he had been unable to lie on his left side without suffering sharp, cramplike pains in the left side of the abdomen. A006374).-The patient, white male, aged 51 years, was admitted to the State of Wisconsin General Hospital on Dec. The following case is reported because it represents a type of internal hernia which has not been previously described, according to a search of the available literature, and because the roentgen diagnostic signs appear to be quite pathognomonic.Ĭase Report (X-ray No. When obstruction of severe grade is present, the diagnostic difficulties are increased (3). The barium-filled loops of small bowel tend to be collected in a compact mass and the actual entrance and exit of the loops of bowel into the hernial sac may be demonstrated (2). Less difficulty is encountered when only the small intestine is involved. The presence of an intra-abdominal hernia may produce a confusing picture on roentgenologic examination of the intestinal tract because of the anomalous position of the intestinal viscera. For some locations only a few cases have been reported. The abdominal fossa-commonly involved and the relative frequency of herniation at the various sites may be obtained from Table I.Īccording to this compilation, herniation into the left paraduodenal fossa is the most common. The total number of recorded cases as listed by them is 467. The last mentioned authors have tabulated the articles on internal hernia appearing since Moynihan and Dobson's summary. This subject has been reviewed by Moynihan and Dobson (6), in 1906, by Short (7), in 1925, and recently by Hansmann and Morton (3). Internal abdominal hernia is an uncommon condition, the nature of which often is not recognized before surgical intervention.
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