Ricerc@Sapienza

Introduction. Intersigmoid hernia is a hernia of the small bowel into the intersigmoid fossa. It is well known to be a rare
condition. Recent reports reveal that the preoperative differentiation of intersigmoid hernias is difficult and the diagnosis is
often confirmed during the laparotomic exploration. Due to the vague clinical manifestation in most cases, the surgical
treatment is frequently delayed. Materials and Methods. In this study, we systematically reviewed the literature up to 2019
covering 114 studies and 124 patients with an intersigmoid hernia. &e purpose of this work is to improve the understanding of
the anatomical aspects, clinical presentation, diagnosis, and treatment of intersigmoid hernia so as to assist the preoperative
differentiation of these hernias when presented as acute abdomen in the emergency department. Results. &e diameter of the
intersigmoid recess was reported with mean 2.65 cm (range 1–10 cm, SD 1.15 cm) and the length of the incarcerated small
intestine was between 3 cm (min) and 150 cm (max): mean 25.25 cm, SD 35.04 cm. &e diameter of the sigmoid recess was
greater in patients who underwent resection due to strangulation (mean 3.31 cm, SD 1.53 cm) compared to those who underwent
only reduction of the hernia (mean 2.35 cm, SD 0.74 cm). &e time from onset to operation was less in patients
undergoing resection surgery due to throttling (mean 3.03 days, SD 3.01 days) compared to those who underwent only a
reduction of hernia incarceration (mean 8.49 days, SD 6.83 days). Conclusion. Intersigmoid hernia is often a forgotten diagnosis
and a clinical challange due to its anatomical characteristics.