INTERNAL HERNIA IN ADULTS

Background. Congenital bands, congenital anomalies of the intestinal r otation and congenital defects in the mesentery or omentum, postsurgic al or traumatic defects of the mesentery and omentum are important fac tors that predispose to internal herniation, In this retrospective stu dy, 18 cases of internal herniation were evaluated and the factors tha t effect the prognosis were investigated; Methods, The records of 609 patients who underwent laparotomy due to acute intestinal obstruction were retrospectively reviewed. The cause of intestinal obstruction was internal herniation in 18 patients. The patients were evaluated with respect to signs and symptoms, radiological findings, time elapsed bet ween the onset of symptoms and surgery, findings, in surgery, type of operation performed, postoperative complications and postoperative sta y. Results. Postoperative complications were encountered more frequent ly in the patients with bowel strangulation (p = 0.045) in our series. Time elapsed between the onset of symptoms and laparotomy was found t o be significantly longer in the patients with strangulation than in t hose without strangulation (p = 0.046), Additionally, postoperative ho spital stay was shorter in the patients without strangulation (p = 0.0 3). Conclusions. Since preoperative diagnosis of an internal herniatio n is very difficult because of the lack of specific signs and symptoms , postoperative complications can only be decreased with early surgica l intervention in the patients with acute intestinal obstruction.