World Journal of Medical and Surgical Case Reports Volume No 10

Case Report Open Access

An ambiguous type of primary internal hernia as the cause of small bowel obstruction a case report

Dr. Majd Alobied
World Journal of Medical and Surgical Case Reports 2020, 9:2



Internal hernia is an important rare cause of small bowel obstruction especially, in a virgin abdomen, without previous abdominal surgery.

Clinical symptoms and signs are nonspecific, and preoperative diagnosis is rare even with modern diagnostic methods.

Clinical presentation

Herein, we report a case of a 60-year- old man who complained of a severe abdominal pain, nausea and obstipation. His clinical examination revealed distended abdomen and high-pitched bowel sounds indicating bowel obstruction. After resuscitation of the patient, laparotomy was done to discover an internal hernia through filmy adhesions in peri -hepatic region, as a new type of primary internal hernia. Next, reduction was done and the patient was discharged after 3 days to be on follow up.


Although there are several common causes of intestinal obstruction (post-surgery adhesions, inguinal hernia, malignancies etc.), other rare causes should be suspected.


filmy adhesions, virgin abdomen, obstipation, abdomen distended.

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