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Sonographic Features of Internal Hernia

Sonoscan Ultrasonic Scan Centre, Coimbatore, India.

Address correspondence to S. Boopathy Vijayaraghavan, MD, DMRD, 16 B Venkatachalam Rd, R. S. Puram, Coimbatore 641 002, India. E-mail: sonoscan{at}vsnl.com or sboopathy{at}eth.net

Objective. The purpose of this series is to describe the sonographic findings in 4 patients with intestinal obstruction due to internal hernia. Methods. Four patients had clinical features of intestinal obstruction. Sonography was performed with broadband convex and linear array transducers in these patients. Results. In all 4 patients, there were features of intestinal obstruction with a zone of transition between dilated and nondilated bowel. There was a cluster of crowded, compressed, and aperistaltic small-bowel loops, as if they were tightly packed within a sac, by the side of this zone in 3 patients. This appearance was due to obstruction of the afferent loop caused by compression. In the last patient, there were 2 loops of dilated bowel within a sac outlined by fluid due to obstruction of the efferent loop. All 4 patients had obstructed internal hernias at laparotomy. Conclusions. Sonographic features of internal hernia are described.

Key Words: internal hernia • paracecal • paraduodenal • sonography

Abbreviations: CT, computed tomography