{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T05:41:59Z","timestamp":1793684519721,"version":"4.5.1"},"reference-count":16,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T00:00:00Z","timestamp":1767052800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T00:00:00Z","timestamp":1767052800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Congenital transmesenteric hernia, an uncommon cause of acute abdomen with an incidence of less than 1%, is often identified only intraoperatively.We present a rare case of internal hernia through a congenital mesenteric defect posterior to the gastric antrum, precipitated by strenuous exercise after a meal in an adolescent.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>A 17-year-old male developed sudden severe abdominal pain and distension after vigorous exercise following a meal. Abdominal computed tomography (CT) demonstrated an abnormally displaced duodenal loop, raising suspicion for internal herniation. Laparoscopic exploration revealed that a large segment of the small bowel had herniated through a congenital mesenteric defect posterior to the gastric antrum into the right upper abdomen. The herniated bowel exhibited clockwise torsion, forming a closed-loop obstruction with strangulated necrosis. Due to extensive necrosis and limited working space, the procedure was converted to an open laparotomy for definitive resection. Following resection of the necrotic bowel, only 6 cm of terminal ileum remained. To preserve the ileocecal valve function, after the viability of both ends was confirmed and with informed consent from the patient\u2019s guardians, an ileo-ileal side-to-side anastomosis was performed to restore intestinal continuity. By postoperative day 7, pelvic drainage was clear, without evidence of anastomotic leakage, and the patient had a smooth recovery and was subsequently discharged.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Emergency physicians should maintain a high index of suspicion for transmesenteric hernia as a potential cause of acute strangulation and bowel necrosis in patients presenting with acute abdomen, and timely surgical intervention is essential. Although long-term outcomes require further evaluation, ileal resection near the ileocecal region with preservation of the valve using a side-to-side anastomosis may represent a salvage strategy under high-risk anatomical conditions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12893-025-03334-5","type":"journal-article","created":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T14:53:40Z","timestamp":1767106420000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Strangulated internal hernia via a congenital posterior gastric antral mesenteric defect in an adolescent: a rare case report and literature review"],"prefix":"10.1186","volume":"25","author":[{"given":"Kangnan","family":"He","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunjie","family":"Ju","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ping","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,12,30]]},"reference":[{"key":"3334_CR1","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1590\/S1516-31802002000300006","volume":"120","author":"GG Duarte","year":"2002","unstructured":"Duarte GG, Fontes B, Poggetti RS, Loreto MR, Motta P, Birolini D. Strangulated internal hernia through the lesser omentum with intestinal necrosis: a case report. Sao Paulo Med J. 2002;120:84\u20136. https:\/\/doi.org\/10.1590\/S1516-31802002000300006.","journal-title":"Sao Paulo Med J"},{"key":"3334_CR2","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1186\/s12893-019-0665-7","volume":"20","author":"Z Liu","year":"2020","unstructured":"Liu Z, He L, Jiao Y, Xu Z, Suo J. An extremely rare case of lesser omental hernia in an elderly female patient following total colectomy. BMC Surg. 2020;20:14. https:\/\/doi.org\/10.1186\/s12893-019-0665-7.","journal-title":"BMC Surg"},{"key":"3334_CR3","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijscr.2022.107361","volume":"96","author":"A Ugianskis","year":"2022","unstructured":"Ugianskis A. Lesser omental hernia without intestinal gangrene \u2013 case report. 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This study complies with the ethical standards of the Declaration of Helsinki. In accordance with ethical requirements and the protection of minors, written informed consent was obtained from both the patient and his legal guardian prior to submission.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Participants\/patient and the guardian gave written informed consent for their personal or clinical details along with any identifying images to be published in this study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"620"}}