Right sided transmesentric hernia: A rare cause of acute abdomen in adults

• Right-sided transmesenteric mesocolic hernias are a rare cause of acute abdomen with few reported cases.
• We report a 30-year-old male with right-sided transmesenteric hernia of ileum due to a congenital mesocolic defect.
• The diagnosis of transmesentric hernia is purely by a CT scan.
• Close monitoring of the patient is essential to identify the rare deteriorating patient for prevention of bowel gangrene.

INTRODUCTIONTransmesenteric mesocolic hernias are a rare cause of acute abdomen in adults with few reported cases in published literature.PRESENTATION OF CASEWe report a rare case of a 30-year-old male with right-sided transmesenteric hernia of ileum due to a congenital mesocolic defect resulting in acute abdomen, presenting as acute abdomen. The hernia was reduced, small bowel inspected for gangrene and mesenteric hernia repaired, following which the patient made a good recovery and was discharged 5 days later.DISCUSSIONThe insidious onset of transmesenteric herniae and lack of specific radiological or laboratory investigations reaffirms the importance of surgeons maintaining a high index of suspicion for this surgical emergency.CONCLUSIONTransmesentric hernia though rare can present as a case of acute abdomen in an emergency. The diagnosis is purely by a CT scan and close monitoring of the patient's general condition in cases of non-specific abdominal pain is essential to identify the rare deteriorating patient for early surgical intervention and optimal outcome.

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