Internal Hernias and Bowel Obstruction Management
Summary
Internal hernias arise when segments of the intestine protrude through congenital or acquired peritoneal or mesenteric defects, accounting for a minority of small bowel obstructions yet posing significant risk of strangulation and ischaemia. The most common subtypes include paraduodenal, foramen of Winslow and broad ligament hernias, alongside rarer variants such as transmesenteric and retroperitoneal defects. Diagnosis is often challenging due to non-specific clinical presentation, necessitating a high index of suspicion and prompt imaging, particularly contrast-enhanced computed tomography. Management centres on timely surgical intervention to reduce herniated loops, assess bowel viability and close the hernial orifice; advances in laparoscopy have refined these approaches, enabling less invasive repair and earlier recovery. Emerging evidence supports the routine closure of peritoneal defects during index pelvic or abdominal surgery to mitigate future herniation, while ongoing research explores novel imaging techniques and enhanced perioperative strategies to improve outcomes.
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Internal Hernias and Bowel Obstruction Management publication trend
The graph below shows the total number of articles in internal hernias and bowel obstruction management across all publications each year (not limited to Nature Index journals).
Technical terms
Internal hernia: Protrusion of intestine through a peritoneal or mesenteric defect without an external sac.
Small bowel obstruction: Mechanical impediment to normal flow of intestinal contents in the small intestine.
Strangulation: Vascular compromise of herniated bowel causing ischaemia and potential necrosis.
Computed tomography (CT): Cross-sectional imaging modality providing detailed evaluation of abdominal structures.
Laparoscopic surgery: Minimally invasive technique using small incisions and camera guidance for intra-abdominal procedures.
Peritoneal defect: Anatomical aperture in the peritoneum or mesentery through which herniation occurs.
References
- Jejunal obstruction due to rare internal hernia between skeletonized external iliac artery and vein as late complication of laparoscopic hysterectomy with pelvic lymphadenectomy—case report and review of literature. Archives of Gynecology and Obstetrics (2020).
- Less invasive treatment for broad ligament hernia: A case report. International Journal of Surgery Case Reports (2020).
- Laparoscopic management of foramen of Winslow incarcerated hernia. Surgical Case Reports (2016).
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