DOI: https://doi.org/10.36347/sjmcr.2025.v13i10.108

Pages: 2638-2640

Introduction: Internal hernias are a rare cause of acute intestinal obstruction, accounting for only 0.5–1% of all cases. Diagnosis relies mainly on computed tomography (CT), and treatment is surgical. Case presentation: We report the case of a 48-year-old woman with no prior medical history, admitted for acute epigastric pain with vomiting. Abdominal CT revealed ectopic small-bowel distension in the right subhepatic region, consistent with an internal hernia. Exploratory laparoscopy confirmed a subhepatic internal hernia through a peritoneal defect forming a ring between the right hepatic lobe, gallbladder, transverse colon, and cholecysto-duodeno-colic ligament. A 20-cm necrotic ileal segment was resected with primary anastomosis. Postoperative recovery was uneventful. Conclusion: Subhepatic internal hernias are extremely rare. CT imaging remains essential for preoperative diagnosis, while laparoscopy represents the preferred surgical approach.