J Korean Soc Radiol.  2010 Feb;62(2):163-165. 10.3348/jksr.2010.62.2.163.

Multidetector-Row CT Findings of an Internal Supravesical Hernia: A Case Report

• Kim SW
• Shin HC
• Kim HH
• Kim YT
• Kim IY
• Kang KH

• KMID: 2208962
• DOI: http://doi.org/10.3348/jksr.2010.62.2.163

Abstract

A supravesical hernia occurs in the supravesical fossa and is either classified as an external or internal supravesical hernia. Most patients with internal supravesical hernias present with small bowel obstruction. Internal supravesical hernias are less common than external supravesical hernia. To date, there are few reports describing the radiological findings of supravesical hernias. To our knowledge, this is the first reported multidetector row CT (MDCT) depiction of this type of hernia. We report here on the MDCT findings of a patient with an internal supravesical hernia presenting with small bowel obstruction.

MeSH Terms

Hernia
Humans
Tomography, X-Ray Computed
Urinary Bladder

Figure

• 

  Fig. 1 A 64-year-old man with internal supravesical hernia. A. Contrast-enhanced axial MDCT image shows a short segment of incarcerated ileal loop (arrows) located anterior to the urinary bladder (UB) on the right. Also note a transitional zone (double arrows). B. Coronal reformatted image shows a site of obstruction (double arrows) around the urinary bladder (UB), incarcerated ileal loop (arrow), proximal loop (P), and distal loop (D). Multiple dilated small bowel loops filled with small bowel feces are also seen. C. Sagittal reformatted image shows an incarcerated ileal loop (arrow) that compresses the anterosuperior wall of the urinary bladder. D. Intraoperative laparoscopy reveals an incarcerated ileal loop through a supravesical fossa on the right side (arrows). UB = urinary bladder.

Reference

1. Takeyama N, Gokan T, Ohgiya Y, Satoh S, Hashizume T, Hataya K, et al. CT of internal hernias. Radiographics. 2005; 25:997–1015.

2. Sasaya T, Yamaguchi A, Isogai M, Harada T, Kaneoka Y, Suzuki M. Supravesical hernia: CT diagnosis. Abdom Imaging. 2001; 26:89–91.

3. Jan YT, Jeng KS, Liu YP, Yang FS. Internal supravesical hernia. Am J Surg. 2008; 196:e27–e28.

4. Mehran A, Szomstein S, Soto F, Rosenthal R. Laparoscopic repair of an internal strangulated supravesical hernia. Surg Endosc. 2004; 18:554–556.

5. Auh YH, Rubenstein WA, Schneider M, Reckler JM, Whalen JP, Kazam E. Extraperitoneal paravesical spaces: CT delineation with US correlation. Radiology. 1986; 159:319–328.

6. Saravanan B, Paramu MK, Ranganathan E. Supravesical hernia - a rare cause of intestinal obstruction. Int J Surg. 2008; 6:471–472.

7. Sozen I, Nobel J. Inguinal mass due to an external supravesical hernia and acute abdomen due to an internal supravesical hernia: a case report and review of the literature. Hernia. 2004; 8:389–392.

8. Kusama M, Kimura K, Koyanagi Y, Ito S, Kaise H, Tamura K. A case of external supravesical hernia. Nippon Geka Gakkai Zasshi. 1993; 94:526–529.

9. Tretbar LL, Gustafson GE. Internal supravesical hernia: a rare hernia causing small bowel obstruction. Am J Surg. 1968; 116:907–908.