Surgical Repair of Treves’ Field Mesenteric Hernia: Use of the Purse-string Technique

Introduction

Mesenteric hernias are a rare type of internal hernia; they can be divided into transmesenteric (hernia due to defect of the mesentery) or mesenteric pouch hernias [1]. Mesenteric defects cause a wide spectrum of lesions, ranging from a hernia involving a short segment of the small bowel to a lesion involving the entire base of the mesentery [2]. Treves’ field mesenteric hernia (TFMH) is a variety of mesenteric hernia and is defined as a defect in the ileum of the mesentery, circumscribed by the branch of the superior mesenteric artery [3] [4]. TFMH are seldom diagnosed prior to surgery and usually manifest as small bowel obstruction with non-specific clinical features. Surgical resection of the involved bowel with primary anastomosis is the most common choice of treatment. Reduction of the hernia with mesenteric repair has been performed only in one case [4].

A 4-year-old girl who developed acute abdomen due to underlying large TFMH is presented here. The clinical features and surgical treatment of TFMH are discussed. A new technique, which simply approximates the mesenteric edges with a purse-string suture, is also proposed.

References

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