Internal hernias occur when there is protrusion of an internal organ into a
retroperitoneal fossa or a
(congenital or acquired) in the
abdominal cavity. If a loop of bowel passes through the mesenteric defect, that loop is at risk for
incarceration,
strangulation
Strangling is compression of the neck that may lead to unconsciousness or death by causing an increasingly hypoxic state in the brain. Fatal strangling typically occurs in cases of violence, accidents, and is one of two main ways that hangin ...
, or for becoming the lead point of a
small bowel obstruction.
Internal hernias can also trap
adipose tissue
Adipose tissue, body fat, or simply fat is a loose connective tissue composed mostly of adipocytes. In addition to adipocytes, adipose tissue contains the stromal vascular fraction (SVF) of cells including preadipocytes, fibroblasts, vascular ...
(fat) and nerves. Unlike more common forms of hernias, the trapped tissue protrudes inward, rather than outward.
Mesenteric defects commonly occur in trauma, such as
gunshot wounds
A gunshot wound (GSW) is a penetrating injury caused by a projectile (e.g. a bullet) from a gun (typically firearm or air gun). Damages may include bleeding, bone fractures, organ damage, wound infection, loss of the ability to move part ...
to the abdomen. In trauma victims, the defect is usually closed, sometimes with resection of the associated bowel, which may have lost its blood supply.
Also mesenteric defects are intentionally created in the
Roux-en-Y gastric bypass procedure, being classically known as a Petersen's hernia.
The mesenteric defect in such cases, called ''Petersen's defect'', is located between the transverse colon and the mesentery of the alimentary limb (the segment of the jejunum from the jejunojejunostomy until the connection with the proximal segment of the stomach) at the level of the jejunojejunostomy.
Internal hernias are difficult to identify in women, and misdiagnosis with
endometriosis or idiopathic
chronic pelvic pain
Pelvic pain is pain in the area of the pelvis. Acute pain is more common than chronic pain. If the pain lasts for more than six months, it is deemed to be chronic pelvic pain. It can affect both the male and female pelvis.
Common causes in inclu ...
is very common. One cause of misdiagnosis that when the woman lies down flat on an examination table, all of the
medical sign
Signs and symptoms are the observed or detectable signs, and experienced symptoms of an illness, injury, or condition. A sign for example may be a higher or lower temperature than normal, raised or lowered blood pressure or an abnormality showi ...
s of the hernia disappear. The hernia can typically only be detected when symptoms are present, so diagnosis requires positioning the woman's body in a way that provokes symptoms.
Both internal hernias and
umbilical hernia
An umbilical hernia is a health condition where the abdominal wall behind the navel is damaged. It may cause the navel to bulge outwards—the bulge consisting of abdominal fat from the greater omentum or occasionally parts of the small intestine ...
s are more common in women than men.
References
{{reflist , 2, refs=
[{{cite news , author=Brody, Jane E , title=In women, hernias may be hidden agony , newspaper=St. Louis Post-Dispatch , date=18 May 2011 , url=http://www.stltoday.com/lifestyles/health-med-fit/health/jane-brody/article_7e2638ac-8959-57bb-9931-6f3aa084f3a1.html]
[{{cite journal , vauthors=Bittner JG, Edwards MA, Harrison SJ, Li K, Karmin PN, Mellinger JD , title=Laparoscopic repair of a right paraduodenal hernia , journal=JSLS , volume=13 , issue=2 , pages=242–9 , year=2009 , pmid=19660226 , pmc=3015939 ]
[{{cite journal , author=Petersen W, title=Über Darmverschlinung nach der Gastroenterostomie , journal=Arch Klin Chir, volume=62, pages=94–114, year=1900]
Hernias