Dealing with intramesosigmoid hernia: A rare variety of internal hernia

Internal hernia, as the cause of acute intestinal obstruction, is rare and sigmoid hernia is not one of the most common internal hernias. Moreover, intramesosigmod hernias are of the rarest variety. Establishing precise preoperative clinical diagnosis is a challenge for a surgeon. Strangulated sigmoid hernia has high morbidity and mortality. Prompt exploration has to be undertaken based on clinical signs and symptoms rather than searching for the exact cause of obstruction. Here, an extremely rare case of intramesosigmoid hernia is presented with a defect in the medial leaf of the mesentery leading to small bowel obstruction.