Internal Supravesical Hernia Revealed by Small Bowel Obstruction

Clinical Image

The supravesical hernia is a rare cause of internal hernia, characterized by the protrusion of the intestine through an abnormal intra-abdominal opening located in the supravesical compartment. This anomaly is infrequently reported in the literature, and its incidence remains uncertain [1]. Supravesical hernias predominantly affect men over the age of 50 [2]. From a pathophysiological perspective, supravesical hernias develop from the supravesical fossae. They form medial to the umbilical arteries and often expand into the Retzius space, though they can also engage laterally, resulting in laterovesical hernias. These hernias are almost always acquired and can sometimes be associated with inguinal hernias. Clinically, they present as acute bowel obstruction. An abdominal CT scan can confirm the diagnosis of obstruction but rarely provides an etiological diagnosis [3]. In such cases, a median laparotomy is necessary, and intraoperative diagnosis is typically straightforward. Treatment involves sectioning the hernial neck and reducing the hernia, followed by simple closure of the opening using separate sutures with absorbable thread [4]. We report a case of a 56-year-old patient with no notable medical history was admitted to the emergency department with an internal supravesical hernia revealed by obstructive syndrome.

    

    

    Figure 1: Small bowel distension upstream of an incarceration of the ileum at an internal supravesical hernia.