BACKGROUND: Internal hernias are uncommon in children and their clinical and imaging findings have not been widely addressed. OBJECTIVE: To determine the spectrum of clinical and imaging findings of internal hernia (IH) in children and to highlight diagnostic features. MATERIALS AND METHODS: Review of clinical, imaging and surgical findings in 12 children with surgically proven IH. RESULTS: IH found in seven girls and five boys. Five of the children were neonates and seven were between ages 8-17 years. All neonates presented acutely and had transmesenteric internal hernias (TMIH) (four congenital, one acquired). In the older children, five presented with chronic symptoms and two presented with acute symptoms; the former had paraduodenal hernias (all congenital) and the latter had a congenital pericecal and an acquired TMIH. Only 2/5 neonatal TMIH could be appreciated on GI contrast examination. All five paraduodenal hernias were easily diagnosed on UGI series. CT, in two older children, depicted a paraduodenal hernia and the acquired TMIH. In 7/10 (70%) congenital IH, there was associated malrotation (in all four right paraduodenal hernias). CONCLUSION: There is a wide spectrum of clinical and imaging findings of IH in children. TMIH were difficult to appreciate on GI contrast examinations, but paraduodenal hernias were easy to appreciate. One must have a high index of suspicion for right paraduodenal hernia if UGI series shows duodenum and proximal small bowel to the right of the spine.
BACKGROUND:Internal hernias are uncommon in children and their clinical and imaging findings have not been widely addressed. OBJECTIVE: To determine the spectrum of clinical and imaging findings of internal hernia (IH) in children and to highlight diagnostic features. MATERIALS AND METHODS: Review of clinical, imaging and surgical findings in 12 children with surgically proven IH. RESULTS: IH found in seven girls and five boys. Five of the children were neonates and seven were between ages 8-17 years. All neonates presented acutely and had transmesenteric internal hernias (TMIH) (four congenital, one acquired). In the older children, five presented with chronic symptoms and two presented with acute symptoms; the former had paraduodenal hernias (all congenital) and the latter had a congenital pericecal and an acquired TMIH. Only 2/5 neonatal TMIH could be appreciated on GI contrast examination. All five paraduodenal hernias were easily diagnosed on UGI series. CT, in two older children, depicted a paraduodenal hernia and the acquired TMIH. In 7/10 (70%) congenital IH, there was associated malrotation (in all four right paraduodenal hernias). CONCLUSION: There is a wide spectrum of clinical and imaging findings of IH in children. TMIH were difficult to appreciate on GI contrast examinations, but paraduodenal hernias were easy to appreciate. One must have a high index of suspicion for right paraduodenal hernia if UGI series shows duodenum and proximal small bowel to the right of the spine.
Authors: Marcos Prada-Arias; L Sanchís-Solera; V Pérez-Candela; A Wiehoff-Neumann; L Alonso-Jiménez; R Beltrá-Picó Journal: J Pediatr Surg Date: 2007-11 Impact factor: 2.545
Authors: Sadi A Abukhalaf; Aya Mustafa; Mohammad N Elqadi; Ahmad Al Hammouri; Khalil N M Abuzaina; Radwan Abukarsh; Ihsan Ghazzawi; Shareef Hassan; Nathan M Novotny Journal: Int J Surg Case Rep Date: 2019-10-10