Internal hernias in children

Spectrum of clinical and imaging findings

Vivian Tang, Alan Daneman, Oscar M. Navarro, Stephen Miller, J. Ted Gerstle

Research output: Contribution to journalArticle

14 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)1559-1568
Number of pages10
JournalPediatric radiology
Volume41
Issue number12
DOIs
StatePublished - Dec 1 2011

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Hernia
Newborn Infant
Duodenum

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Radiology Nuclear Medicine and imaging

Cite this

Internal hernias in children : Spectrum of clinical and imaging findings. / Tang, Vivian; Daneman, Alan; Navarro, Oscar M.; Miller, Stephen; Gerstle, J. Ted.

In: Pediatric radiology, Vol. 41, No. 12, 01.12.2011, p. 1559-1568.

Research output: Contribution to journalArticle

Tang, Vivian ; Daneman, Alan ; Navarro, Oscar M. ; Miller, Stephen ; Gerstle, J. Ted. / Internal hernias in children : Spectrum of clinical and imaging findings. In: Pediatric radiology. 2011 ; Vol. 41, No. 12. pp. 1559-1568.
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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.",
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