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HERO ID
215307
Reference Type
Journal Article
Title
Treves' field congenital hernias in children: an unsuspected rare cause of acute small bowel obstruction
Author(s)
Vaos, G; Skondras, C
Year
2007
Is Peer Reviewed?
1
Journal
Pediatric Surgery International
ISSN:
0179-0358
EISSN:
1437-9813
Volume
23
Issue
4
Page Numbers
337-342
Language
English
Abstract
The Treves' field congenital hernias (TFCH) are an unusual cause of bowel obstruction that may result in irreversible damage of the small bowel or a fatal outcome, unless treated timely and properly. We analyzed retrospectively the medical records of four patients who underwent surgery for TFCHs over a period of 9 years. The types of TFCHs, only diagnosed at surgery, were identified as transmesenteric through a defect in Treves' field in three patients, and as hernia into Treves' field pouch in one patient. Patients had non-specific clinical manifestations, and imaging findings demonstrated only small bowel obstruction. Delay in accurate preoperative diagnosis, and especially patient-related delay, led to a primary enterectomy-anastomosis for necrotic small bowel in the patients with transmesenteric hernias. One infant with necrotic bowel died postoperatively. It may be difficult to diagnose TFCHs in children preoperatively. Misdiagnosis of bowel obstruction caused by this type of internal hernia might lead to small bowel necrosis or death. The risk of this complication seems to be more influenced by pre-hospital delay. Awareness of the severe consequences of delay in diagnosis, high clinical suspicion, early recognition, and proper surgical intervention are essential in the successful management of TFCHs.
Keywords
Child, Preschool; Diagnosis, Differential; Fatal Outcome; Female; Hernia, Ventral/co [Complications]; *Hernia, Ventral/cn [Congenital]; Hernia, Ventral/ra [Radiography]; Humans; Infant, Newborn; *Intestinal Obstruction/et [Etiology]; Intestinal Obstruction/ra [Radiography]; *Intestine, Small; Male; Radiography, Abdominal; Tomography, X-Ray Computed
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