Abstract

Intestinal obstruction due to internal herniations is rare. Internal herniations either congenital or acquired account for a small portion of small bowel obstruction ranging from 0.6 to 5.8 %. Approximately, paracecal herniations are responsible for 2% of these. It is usually diagnosed at laparotomy and emergent surgical therapy is needed. Four areas are reported for paracecal herniations: 1) superior ileocecal recess 2) inferior ileocecal recess 3) retrocecal recess 4) paracolic gutter. Sixty-two years old male patient who had an appendectomy 50 years ago was admitted to emergency service with acute abdomen. Clinically, there was mechanical ileus secondary to the internal herniation due to the defect in paracolic gutter; at the laparotomy what we have found was ileum necrosis. In the recent reviews one case was reported due to herniation at paracolic gutter after appendectomy. In conclusion; paracecal herniation should be considered in adult patients with intestinal obstruction and previous appendectomy.