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Internal Hernia
Ethan A. Smith, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          TERMINOLOGY

          • Definitions

            • Herniation of bowel through mesenteric defect, congenital band, or normal anatomic opening
              • Transmesenteric hernia: Congenital mesenteric defect, usually near ileocecal valve or ligament of Treitz
                • Most common type in children
              • Acquired: Post surgical (iatrogenic) or post traumatic
              • Other types of internal hernias are more common in adults
                • Foramen of Winslow, paraduodenal, pericecal, transomental

          IMAGING

          • General Features

            • Radiographic Findings

              • CT Findings

                • MR Findings

                  • Ultrasonographic Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        CLINICAL ISSUES

                        • Presentation

                          • Demographics

                            • Natural History & Prognosis

                              • Treatment

                                DIAGNOSTIC CHECKLIST

                                • Image Interpretation Pearls

                                  • Reporting Tips

                                    Selected References

                                    1. Dou L et al: Adhesive and non-adhesive internal hernia: clinical relevance and multi-detector CT images. Sci Rep. 9(1):12847, 2019
                                    2. Shi Y et al: Congenital left paraduodenal hernia causing chronic abdominal pain and abdominal catastrophe. Pediatrics. 135(4):e1067-71, 2015
                                    3. Lee N et al: Congenital internal hernia presented with life threatening extensive small bowel strangulation. Pediatr Gastroenterol Hepatol Nutr. 16(3):190-4, 2013
                                    4. Page MP et al: Newborn and toddler intestinal obstruction owing to congenital mesenteric defects. J Pediatr Surg. 43(4):755-8, 2008
                                    5. Martin LC et al: Review of internal hernias: radiographic and clinical findings. AJR Am J Roentgenol. 186(3):703-17, 2006
                                    6. Takeyama N et al: CT of internal hernias. Radiographics. 25(4):997-1015, 2005
                                    7. Blachar A et al: Internal hernia: clinical and imaging findings in 17 patients with emphasis on CT criteria. Radiology. 218(1): 68-74, 2001
                                    Related Anatomy
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                                    Related Differential Diagnoses
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                                    References
                                    Tables

                                    Tables

                                    KEY FACTS

                                    • Terminology

                                      • Imaging

                                        • Top Differential Diagnoses

                                          • Clinical Issues

                                            TERMINOLOGY

                                            • Definitions

                                              • Herniation of bowel through mesenteric defect, congenital band, or normal anatomic opening
                                                • Transmesenteric hernia: Congenital mesenteric defect, usually near ileocecal valve or ligament of Treitz
                                                  • Most common type in children
                                                • Acquired: Post surgical (iatrogenic) or post traumatic
                                                • Other types of internal hernias are more common in adults
                                                  • Foramen of Winslow, paraduodenal, pericecal, transomental

                                            IMAGING

                                            • General Features

                                              • Radiographic Findings

                                                • CT Findings

                                                  • MR Findings

                                                    • Ultrasonographic Findings

                                                      • Imaging Recommendations

                                                        DIFFERENTIAL DIAGNOSIS

                                                          CLINICAL ISSUES

                                                          • Presentation

                                                            • Demographics

                                                              • Natural History & Prognosis

                                                                • Treatment

                                                                  DIAGNOSTIC CHECKLIST

                                                                  • Image Interpretation Pearls

                                                                    • Reporting Tips

                                                                      Selected References

                                                                      1. Dou L et al: Adhesive and non-adhesive internal hernia: clinical relevance and multi-detector CT images. Sci Rep. 9(1):12847, 2019
                                                                      2. Shi Y et al: Congenital left paraduodenal hernia causing chronic abdominal pain and abdominal catastrophe. Pediatrics. 135(4):e1067-71, 2015
                                                                      3. Lee N et al: Congenital internal hernia presented with life threatening extensive small bowel strangulation. Pediatr Gastroenterol Hepatol Nutr. 16(3):190-4, 2013
                                                                      4. Page MP et al: Newborn and toddler intestinal obstruction owing to congenital mesenteric defects. J Pediatr Surg. 43(4):755-8, 2008
                                                                      5. Martin LC et al: Review of internal hernias: radiographic and clinical findings. AJR Am J Roentgenol. 186(3):703-17, 2006
                                                                      6. Takeyama N et al: CT of internal hernias. Radiographics. 25(4):997-1015, 2005
                                                                      7. Blachar A et al: Internal hernia: clinical and imaging findings in 17 patients with emphasis on CT criteria. Radiology. 218(1): 68-74, 2001