Clinical Snapshot
Incarcerated Jejunal Hernia Following Lumbar Vertebral Fracture
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A patient in their 60s presented in September 2024 with a 3-day history of progressive weakness, malaise, decreased appetite, and non-projectile postprandial vomiting, without motor deficits or fever. The patient had sustained an L4 vertebral fracture 1 month earlier, which had been managed conservatively without surgical intervention. Abdominal CT (Figure A, B) demonstrated discontinuity of the L4 vertebral body with separated fracture fragments. Emergency laparotomy revealed jejunal incarceration at the L4 fracture site, with necrosis and perforation of an approximately 6-cm long section of the bowel. Resection of the necrotic segment with jejunojejunostomy was performed. At 2-week follow-up, bowel function was restored without evidence of anastomotic leakage. This case illustrates a rare hernia variant: jejunal incarceration within a lumbar vertebral fracture (only 12 cases reported globally between 1979 and 2016). It underscores the need to consider traumatic or spinal abnormalities in atypical intestinal obstructions.
Funding: Clinical Research Center for Medical Imaging in Jiangxi Province [Grant number 20223BCG7400199].
Junhua Hu, MD, Medical Imaging Center, The Fifth People‘s Hospital of Jingdezhen, Jingdezhen, Jiangxi, China
Cailiang Zhang, MD, Department of General Surgery, Ganzhou People‘s Hospital, China
Binglin Lai, MD, Ganzhou Institute of Medical Imaging, Ganzhou Key Laboratory of Medical Imaging and Artificial Intelligence, Medical Imaging Center, Ganzhou People‘s Hospital, Ganzhou Hospital-Nanfang Hospital, Southern Medical University, China, binglin723.lai@outlook.com
Conflict of interest statement: The authors declare that no conflict of interest exists.
Cite this as: Hu J, Zhang C, Lai B: Incarcerated jejunal hernia following lumbar vertebral fracture. Dtsch Arztebl Int 2025; 122: 734. DOI: 10.3238/arztebl.m2025.0175
