A Rare Case of Left Mesocolic Hernia
Chronic Abdominal Pain: Not Always Non-Specific
A Rare Case of Left Mesocolic Hernia
Chronic abdominal pain is a common complaint in children, often attributed to non-specific causes like irritable bowel syndrome or functional abdominal pain. However, it’s crucial to consider underlying anatomical abnormalities that can mimic these conditions.
A Complex Case: A 9-year-old boy presented with acute, colicky abdominal pain and bilious vomiting for three days. His medical history revealed a history of episodic abdominal pain dating back three years. A physical examination revealed abdominal distension, visible bowel loops, hyperperistalsis, and voluntary guarding.
The Culprit: A Rare Hernia Radiological investigations, including X-ray of the abdomen, confirmed the presence of multiple air-fluid levels, indicative of intestinal obstruction. Further evaluation led to the diagnosis of a left mesocolic hernia, a rare congenital anomaly characterized by the entrapment of a significant portion of the small intestine within a peritoneal sac formed by the mesentery of the descending colon.
A Delicate Surgical Procedure: The patient underwent emergency surgery to address the acute intestinal obstruction and repair the hernia. The surgical procedure involved carefully dissecting the entrapped bowel from the hernial sac and releasing the constriction caused by the inferior mesenteric artery.
A Successful Outcome: Post-operatively, the patient recovered well and was discharged from the hospital. Regular follow-up is essential to monitor for any recurrence or complications.
The Importance of Early Diagnosis:
This case highlights the importance of a thorough evaluation and early diagnosis of chronic abdominal pain in children. While non-specific causes are often considered, it’s crucial to rule out underlying anatomical abnormalities like hernias. Early diagnosis and timely intervention can prevent complications such as intestinal obstruction and significantly improve patient outcomes.
A Call for Awareness: As healthcare providers, we must remain vigilant and consider rare conditions like left mesocolic hernia in the differential diagnosis of chronic abdominal pain. By raising awareness about this condition, we can improve early diagnosis and patient care.
Dr. Arjun Pawar is a Consultant Pediatric Surgeon at Divine Pediatric Surgery Centre, Vedant Balrugnalay and Critical Care Centre, Garkheda, Chh. Sambhajinagar
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