Strangulated Trans Epiploic Hernia: A Rare Case Report and Review of Literature

Abstract

Internal hernias are protrusions of the abdominal hollow viscera into an intraperitoneal orifice, but which remain within the abdominal cavity. This does not include iatrogenic post-surgical forms, the most frequent of which are currently observed after orthotopic liver transplants and laparoscopic gastrojejunal shunts with Y-loop anastomosis.  The different varieties of internal hernia are usually presented according to their relative frequency and anatomical location, according to the classification proposed by Welch in 1958 and used in most published works: Paraduodenal 50-55%, pericæcal 10-15% transmesenteric 8-10%, foramen of Winslow 6-10%, intersigmoid 4-8%, pelvic 6%, including broad ligament 4-5%. We report the case of a 66-year-old patient, followed for diffuse interstitial lung disease at fibrosis stage for 4 years, diabetic on insulin for 20 years, hypertensive on amlodipine for 4 years. Admitted to our department in an emergency setting for an occlusive syndrome, clinically the patient presented with a tympanic distended abdomen. A CT scan revealed a gallbladder occlusion and surgical exploration revealed a transepilpoic internal hernia.