Korean J Leg Med.  2012 May;36(1):102-106. 10.7580/KoreanJLegMed.2012.36.1.102.

Hemorrhagic Infarction of the Small Intestine due to Transmesenteric Hernia in an Adolescent: A Case Report

• Choi M
• Park JH
• Jeon SH
• Lee HY
• Seo JS
• Kim HJ

• KMID: 2250325
• DOI: http://doi.org/10.7580/KoreanJLegMed.2012.36.1.102

Abstract

Transmesenteric hernia is so infrequent that sudden unexpected death due to this condition is a very rare occurrence. Because the disease usually occurs in pediatric populations, it is a very rarely observed in adolescents or adults. We report an autopsy case of transmesenteric hernia diagnosed postmortem in an 18-year-old boy who died suddenly after complaining of acute abdominal pains with nausea. Physical examinations, simple abdominal radiographs, and abdominal CT scans failed to provide a clear diagnosis of the illness for 37 h in the hospital. At autopsy, a small round defect of the small bowel mesentery was found, through which a long segment of the small intestine herniated, accompanied by hemorrhagic infarction induced by strangulation obstruction. We would like to present and review this rare autopsy case with medicolegal viewpoints.

Keyword

transmesenteric hernia; hemorrhagic infarction; small intestine; sudden death; adolescent

MeSH Terms

Abdominal Pain
Adolescent
Adult
Autopsy
Death, Sudden
Hernia
Humans
Infarction
Intestine, Small
Mesentery
Nausea
Physical Examination

Figure

• 

  Fig. 1 The dark black discolored segment of small bowel is seen with about 2300 cc of bloody exudate in peritoneal cavity.

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  Fig. 2 A small round defect of small bowel mesentery is found at pedicle of the mesentery. The herniated ileum shows a transitional zone formed by constriction of the hole-like defect.

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  Fig. 3 The mesenteric defect is measured about 3.5 cm in diameter.

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  Fig. 4 The herniated ileum mucosa shows transmural hemorrhagic necrosis filled with bloody contents.

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