{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T08:54:47Z","timestamp":1772268887362,"version":"3.50.1"},"reference-count":17,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T00:00:00Z","timestamp":1772150400000},"content-version":"unspecified","delay-in-days":26,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007162","name":"University of Nevada, Las Vegas","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007162","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,1,22]]},"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:p>A female in her late 20s presented to the emergency department with 1\u2009day of right lower quadrant pain, nausea and emesis. Imaging demonstrated an exophytic right ovarian cyst in addition to small bowel in the pelvis with faecalisation and fat stranding. The patient was taken emergently to the operating room for a joint procedure with the gynaecology team, consisting of a diagnostic laparoscopy and cystectomy. In the operating room, she was found to have small bowel incarcerated within a defect in the pouch of Douglas. This is a rare case in which a small bowel obstruction was caused by an internal hernia within the pouch of Douglas.<\/jats:p>","DOI":"10.1136\/bcr-2025-269162","type":"journal-article","created":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T05:05:16Z","timestamp":1772255116000},"page":"e269162","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Rare internal hernia: small bowel incarcerated within pouch of Douglas"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-3348-7496","authenticated-orcid":false,"given":"Brenna","family":"Chen","sequence":"first","affiliation":[{"name":"General Surgery, University of Nevada Las Vegas Kirk Kerkorian School of Medicine, Las Vegas, Nevada, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Kelecy","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Nevada Las Vegas, Las Vegas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maritza","family":"Kelesis","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, University of Louisville, Louisville, Kentucky, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Baynosa","sequence":"additional","affiliation":[{"name":"University of Nevada Las Vegas, Las Vegas, Nevada, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,2,27]]},"reference":[{"key":"2026022721051323000_19.2.e269162.1","doi-asserted-by":"crossref","unstructured":"Rami Reddy SR , Cappell MS . A Systematic Review of the Clinical Presentation, Diagnosis, and Treatment of Small Bowel Obstruction. Curr Gastroenterol Rep 2017;19. doi:10.1007\/s11894-017-0566-9","DOI":"10.1007\/s11894-017-0566-9"},{"key":"2026022721051323000_19.2.e269162.2","first-page":"20","article-title":"Internal hernias: a difficult diagnostic challenge. Review of CT signs and clinical findings","volume":"90","author":"Monica","year":"2019","journal-title":"Acta Bio Medica: Atenei Parmensis"},{"key":"2026022721051323000_19.2.e269162.3","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1007\/s13126-020-0562-7","article-title":"Internal Hernia through a Congenital Peritoneal Defect in the Pouch of Douglas causing Small Bowel Obstruction","volume":"92","author":"Kounoudes","year":"2020","journal-title":"Hellenic J Surg"},{"key":"2026022721051323000_19.2.e269162.4","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/00219246-200507310-00001","article-title":"Abdominal Internal Hernias: Radiographic Findings","volume":"28","author":"Martin","year":"2005","journal-title":"Contemporary Diagnostic Radiology"},{"key":"2026022721051323000_19.2.e269162.5","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/j.ijscr.2012.10.015","article-title":"Internal hernia through a peritoneal defect in the pouch of Douglas: Report of a case","volume":"4","author":"Suwa","year":"2013","journal-title":"Int J Surg Case Rep"},{"key":"2026022721051323000_19.2.e269162.6","doi-asserted-by":"crossref","first-page":"1305","DOI":"10.2214\/ajr.179.5.1791305","article-title":"CT of internal hernia through a peritoneal defect of the pouch of Douglas","volume":"179","author":"Inoue","year":"2002","journal-title":"AJR Am J Roentgenol"},{"key":"2026022721051323000_19.2.e269162.7","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1177\/000313481007600513","article-title":"Perineal hernia: surgical anatomy, embryology, and technique of repair","volume":"76","author":"Stamatiou","year":"2010","journal-title":"Am Surg"},{"key":"2026022721051323000_19.2.e269162.8","article-title":"Small Bowel Obstruction Caused by Internal Hernia through a Peritoneal Defect of the Pouch of Douglas: Report of a Case and Review of the Literature","volume":"2017","author":"Choi","year":"2017","journal-title":"Case Rep Surg"},{"key":"2026022721051323000_19.2.e269162.9","doi-asserted-by":"crossref","first-page":"196","DOI":"10.4103\/ijabmr.IJABMR_297_16","article-title":"Report of a Case and Review of Literature of Internal Hernia through Peritoneal Defect in Pouch of Douglas: A Rare Occurrence","volume":"7","author":"Muthukumar","year":"2017","journal-title":"Int J Appl Basic Med Res"},{"key":"2026022721051323000_19.2.e269162.10","article-title":"A Pelvic Hernia Through Two Defects in the Pouch of Douglas in a Patient With Peritoneal Xanogranuloma: A Report of a Very Rare Case","volume":"16","author":"Rabai","year":"2024","journal-title":"Cureus"},{"key":"2026022721051323000_19.2.e269162.11","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.218.1.r01ja5368"},{"key":"2026022721051323000_19.2.e269162.12","doi-asserted-by":"crossref","first-page":"14","DOI":"10.31080\/ASMS.2022.06.1234","article-title":"Small Bowel Obstruction Secondary to an Internal Hernia Through the Pouch of Douglas: A Case Report and Review of the Literature","volume":"6","author":"Guelmo-Daisley","year":"2022","journal-title":"Act Scie Medic"},{"key":"2026022721051323000_19.2.e269162.13","doi-asserted-by":"crossref","first-page":"271","DOI":"10.4103\/jmas.JMAS_79_19","article-title":"Pouch of Douglas internal hernia successfully treated laparoscopically","volume":"16","author":"Hari","year":"2020","journal-title":"J Minim Access Surg"},{"key":"2026022721051323000_19.2.e269162.14","first-page":"537","article-title":"Internal Richter\u2019s hernia due to congenital peritoneal defect","volume":"154","author":"Fitzgaard","year":"1988","journal-title":"Case Report\u201d Acta Chirurgica Scandanavica"},{"key":"2026022721051323000_19.2.e269162.15","doi-asserted-by":"publisher","DOI":"10.1259\/0007-1285-65-779-1045"},{"key":"2026022721051323000_19.2.e269162.16","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1007\/s10029-011-0788-y","article-title":"Pouch of Douglas pelvic hernia: a rare entity managed laparoscopically","volume":"16","author":"Bunni","year":"2012","journal-title":"Hernia"},{"key":"2026022721051323000_19.2.e269162.17","doi-asserted-by":"crossref","first-page":"258","DOI":"10.7439\/ijbar.v4i4.332","article-title":"A rare case of internal hernia through a rent in Pouch of Douglas, six years after abdominal hysterectomy","volume":"4","author":"Apturkar","year":"2013","journal-title":"Int J of Biomed & Adv Res"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-269162","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T05:05:20Z","timestamp":1772255120000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-269162"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2]]},"references-count":17,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,2,27]]},"published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10.1136\/bcr-2025-269162"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-269162","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2]]}}}