Rare Internal Herniation of The Terminal Ileum into a Retroperitoneal Fossa: A Case Report

Introduction: The causes of acute abdomen can riddle many surgeons and clinicians as a whole, amongst which internal hernias are can be illusive puzzles. While clinical history and examination are helpful, they are often nonspecific for internal hernias. The role of imaging can’t be overstated in diagnosing the cause of acute abdomen, but we are sometimes welcomed with a completely different picture in theatre than what was diagnosed preoperatively. Case Presentation: We report a case of a 22year old man, with about a week’s history of abdominal pains. Laparotomy revealed a loop of terminal ileum and omentum strangulated in an inferior ileocaecal, retroperitoneal pouch. Conclusion: The causes of acute abdomen remain to be a mysterious medical phenomenon with a vast array of possibilities. Diagnosing this sometimes comes with difficulty, especially with limited resources. Complete understanding of the aetiology sometimes occurs only at the point of surgical intervention.