AUTHOR=Wang Lan , Zhu Yuchun , Tan Huayun 

TITLE=Internal hernia through the mesenteric defect in twin pregnancy: a case report and literature review

JOURNAL=Frontiers in Medicine

VOLUME=Volume 11 - 2024

YEAR=2024

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2024.1479634

DOI=10.3389/fmed.2024.1479634

ISSN=2296-858X

ABSTRACT=Internal Hernia through the Mesenteric Defect in Twin Pregnancy: A Case Report and Literature Review Background: Internal hernias through mesenteric defects are rare, particularly in the context of twin pregnancies, and can lead to severe complications such as bowel obstruction and strangulation. Early diagnosis is critical, yet challenging, due to the overlapping symptoms with other abdominal conditions and the limited use of advanced imaging during pregnancy.Case Description: We present a 33-year-old woman with a twin pregnancy at 33+2 weeks of gestation who experienced acute bowel obstruction due to an internal hernia through a congenital mesenteric defect. The patient presented with persistent upper abdominal pain, nausea, and vomiting. Given the advanced stage of pregnancy and the associated risks, a cesarean section was performed, followed by surgical exploration. Approximately one meter of strangulated small intestine was resected, and the mesenteric defect was repaired. Both mother and infants recovered uneventfully.Conclusions: This case highlights the importance of considering internal hernia in the differential diagnosis of acute abdominal pain during pregnancy. Prompt surgical intervention is crucial to prevent maternal and fetal morbidity.