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1/2023
vol. 88 Gastrointestinal and abdominal radiology
abstract:
Original paper
Computed tomography findings of intersigmoid hernia
Yuki Tashiro
1
,
Nobuyuki Takeyama
1
,
Mana Kachi
1
,
Kazuhiro Kijima
2
,
Takahiro Umemoto
2
,
Kuniya Tanaka
2
,
Kiyotaka Ryu
3
,
Shuichi Satoh
4
,
Toshi Hashimoto
1
1.
Department of Radiology, Showa University Fujigaoka Hospital, Yokohama, Japan
2.
Department of General and Gastroenterological Surgery, Showa University Fujigaoka Hospital, Yokohama, Japan
3.
Department of Radiology, Kikuna Memorial Hospital, Yokohama, Japan
4.
Department of Radiology, Yokohama Asahi Chuo General Hospital, Yokohama, Japan
© Pol J Radiol 2023; 88: e231-e237
Online publish date: 2023/05/05
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Purpose:
To evaluate the computed tomography findings of intersigmoid hernias. Material and methods: Between April 2010 and March 2018, 7 patients who were surgically diagnosed with intersigmoid hernia in 3 institutions were enrolled in this study. Two radiologists evaluated imaging findings for the herniated small bowel, the distance between the occlusion point and bifurcation of the left common iliac artery, and the anatomic relationship with adjacent organs. Results: All patients were male, and their mean age (standard deviation, range) was 61.0 (13.5, 36-85) years. The mean size of the bowel loops was 5.2 (1.3, 4.0-8.3) cm in the caudal direction, 3.6 (0.8, 2.5-5.1) cm in the lateral, and 3.4 (0.6, 2.5-4.7) cm in the anterior-posterior direction. The volume was 37.9 (27.8, 15.6-103.0) cm3 approximated by an ellipse, and 24.0 (17.7, 9.9-65.6) cm3 approximated by a truncated cone. The obstruction point was located 3.6 (0.6, 2.8-4.7) cm inferior to the bifurcation of the left common iliac artery. In all cases, the small bowel ran under the point at which the inferior mesenteric vessels bifurcated to the superior rectal vessels and the sigmoid vessels and formed a sac-like appearance between the left psoas muscle and the sigmoid colon. The ureter ran dorsal to the point of the bowel stenosis, and the left gonadal vein ran outside the small bowel loops. Conclusions: All cases showed common imaging findings, which may be characteristic of men’s intersigmoid hernia. In addition, the fossa’s position was lower, and the size was larger than in the previous study, which may be a risk factor. keywords:
internal hernia, intersigmoid hernia, intersigmoid fossa |