Congenital internal hernia through defect in the falciform ligament in adult: A case report and review of the literature

Highlights • The incidence of occlusion syndrome caused by internal hernia is very rare. • The diagnostic laparoscopic approach has shown to be the best. • Herniation of a loop of small bowel through a hole in the falciform ligament was solved by the division of part of falciform ligament without intestinal resection.
Introduction The incidence of occlusion syndrome caused by internal hernia is very rare, in particular when the defect is congenital discovered in adults with no previous abdominal surgery. Presentation of case We present a case of a 31 year-old female patient who presented with acute abdominal pain and mechanical obstruction. The patient had never undergone abdominal surgery. Discussion On diagnostic laparoscopy, it was found a herniation of a loop of small bowel through a hole in the falciform ligament. The obstruction was solved by the division of part of falciform ligament without intestinal resection. Conclusion Internal hernia is a very uncommon pathology, most often discovered in pediatric age because of congenital abnormalities, it must be included in the differential diagnosis in adults. Preoperative diagnosis is difficult. The diagnostic laparoscopic approach has shown to be the best.