Abstract:
BACKGROUND:Internal hernias are uncommon in children and their clinical and imaging findings have not been widely addressed. OBJECTIVE:To determine the spectrum of clinical and imaging findings of internal hernia (IH) in children and to highlight diagnostic features. MATERIALS AND METHODS:Review of clinical, imaging and surgical findings in 12 children with surgically proven IH. RESULTS:IH found in seven girls and five boys. Five of the children were neonates and seven were between ages 8-17 years. All neonates presented acutely and had transmesenteric internal hernias (TMIH) (four congenital, one acquired). In the older children, five presented with chronic symptoms and two presented with acute symptoms; the former had paraduodenal hernias (all congenital) and the latter had a congenital pericecal and an acquired TMIH. Only 2/5 neonatal TMIH could be appreciated on GI contrast examination. All five paraduodenal hernias were easily diagnosed on UGI series. CT, in two older children, depicted a paraduodenal hernia and the acquired TMIH. In 7/10 (70%) congenital IH, there was associated malrotation (in all four right paraduodenal hernias). CONCLUSION:There is a wide spectrum of clinical and imaging findings of IH in children. TMIH were difficult to appreciate on GI contrast examinations, but paraduodenal hernias were easy to appreciate. One must have a high index of suspicion for right paraduodenal hernia if UGI series shows duodenum and proximal small bowel to the right of the spine.
journal_name
Pediatr Radioljournal_title
Pediatric radiologyauthors
Tang V,Daneman A,Navarro OM,Miller SF,Gerstle JTdoi
10.1007/s00247-011-2158-4subject
Has Abstractpub_date
2011-12-01 00:00:00pages
1559-68issue
12eissn
0301-0449issn
1432-1998journal_volume
41pub_type
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