Congenital internal hernia in the neonate: Case series with review of potential comorbidities and imaging findings

Internal hernias are a rare but serious complication that typically present in older children and adults and can be congenital or iatrogenic in origin. They are often difficult to diagnose due to their similar radiological and clinical presentation to more common abdominal pathologies. We describe t...

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Main Authors: Zachary Swenson, Dhara Kinariwala, Chioma Moneme, Eugene McGahren, Reza Daugherty
Format: Article
Language:English
Published: Elsevier 2023-04-01
Series:Journal of Pediatric Surgery Case Reports
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2213576623000222
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author Zachary Swenson
Dhara Kinariwala
Chioma Moneme
Eugene McGahren
Reza Daugherty
author_facet Zachary Swenson
Dhara Kinariwala
Chioma Moneme
Eugene McGahren
Reza Daugherty
author_sort Zachary Swenson
collection DOAJ
description Internal hernias are a rare but serious complication that typically present in older children and adults and can be congenital or iatrogenic in origin. They are often difficult to diagnose due to their similar radiological and clinical presentation to more common abdominal pathologies. We describe three cases of congenital internal hernias presenting in preterm infants followed by a literature review of congenital internal hernias presenting shortly after birth. When presenting in the neonatal period, congenital internal hernias have been exclusively reported as transmesenteric type. The exact etiology of transmesenteric congenital internal hernias is unclear, but may be a result of vascular compromise to the mesentery creating a small defect in which bowel may become entrapped. Certain genetic factors may also play a role in increasing risk for congenital internal hernias as they can be comorbid with other pathologies. Delayed diagnosis postpones surgical treatment, increasing risk of hernia incarceration, strangulation, irreversible bowel ischemia, and long-term risks inherent to bowel resection. Multimodal imaging plays a key role in the evaluation of these infants by excluding many causes of neonatal intestinal obstruction, however, a definitive prospective radiologic diagnosis has not been reported to date. Radiographic findings and comorbidities associated with these cases can be used along with future reported cases to potentially aid in timely diagnosis.
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spelling doaj.art-8da9e0d8f31043019beffbf2c9f3abe02023-03-18T04:41:04ZengElsevierJournal of Pediatric Surgery Case Reports2213-57662023-04-0191102596Congenital internal hernia in the neonate: Case series with review of potential comorbidities and imaging findingsZachary Swenson0Dhara Kinariwala1Chioma Moneme2Eugene McGahren3Reza Daugherty4Department of Radiology and Medical Imaging, University of Virginia, 1215 Lee Street, Charlottesville, VA, 22901, USA; Corresponding author.Department of Radiology and Medical Imaging, University of Virginia, 1215 Lee Street, Charlottesville, VA, 22901, USADepartment of Surgery, University of Virginia, 1215 Lee Street, Charlottesville, VA, 22901, USADivision of Pediatric Surgery, Department of Surgery, University of Virginia, 1215 Lee Street, Charlottesville, VA, 22901, USADivision of Pediatric Radiology, Department of Radiology and Medical Imaging, University of Virginia, 1215 Lee Street, Charlottesville, VA, 22901, USAInternal hernias are a rare but serious complication that typically present in older children and adults and can be congenital or iatrogenic in origin. They are often difficult to diagnose due to their similar radiological and clinical presentation to more common abdominal pathologies. We describe three cases of congenital internal hernias presenting in preterm infants followed by a literature review of congenital internal hernias presenting shortly after birth. When presenting in the neonatal period, congenital internal hernias have been exclusively reported as transmesenteric type. The exact etiology of transmesenteric congenital internal hernias is unclear, but may be a result of vascular compromise to the mesentery creating a small defect in which bowel may become entrapped. Certain genetic factors may also play a role in increasing risk for congenital internal hernias as they can be comorbid with other pathologies. Delayed diagnosis postpones surgical treatment, increasing risk of hernia incarceration, strangulation, irreversible bowel ischemia, and long-term risks inherent to bowel resection. Multimodal imaging plays a key role in the evaluation of these infants by excluding many causes of neonatal intestinal obstruction, however, a definitive prospective radiologic diagnosis has not been reported to date. Radiographic findings and comorbidities associated with these cases can be used along with future reported cases to potentially aid in timely diagnosis.http://www.sciencedirect.com/science/article/pii/S2213576623000222Neonatal imagingGastrointestinal imagingCongenital anomalies
spellingShingle Zachary Swenson
Dhara Kinariwala
Chioma Moneme
Eugene McGahren
Reza Daugherty
Congenital internal hernia in the neonate: Case series with review of potential comorbidities and imaging findings
Journal of Pediatric Surgery Case Reports
Neonatal imaging
Gastrointestinal imaging
Congenital anomalies
title Congenital internal hernia in the neonate: Case series with review of potential comorbidities and imaging findings
title_full Congenital internal hernia in the neonate: Case series with review of potential comorbidities and imaging findings
title_fullStr Congenital internal hernia in the neonate: Case series with review of potential comorbidities and imaging findings
title_full_unstemmed Congenital internal hernia in the neonate: Case series with review of potential comorbidities and imaging findings
title_short Congenital internal hernia in the neonate: Case series with review of potential comorbidities and imaging findings
title_sort congenital internal hernia in the neonate case series with review of potential comorbidities and imaging findings
topic Neonatal imaging
Gastrointestinal imaging
Congenital anomalies
url http://www.sciencedirect.com/science/article/pii/S2213576623000222
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