Transmesenteric hernia, a type of internal hernias, is a rare cause of intestinal obstruction. This intraperitoneal hernia has no sac and is formed by protrusion of a loop of bowel through an aperture in the mesentery. Incarceration leads to
intestinal
obstruction and subsequently, strangulation and gangrene of varing lengths of intestine. This is a case report of 4-year-old girl with transmesenteric herniation of the terminal ileum through a defect in its own mesentery. Strangulation of the
affected
bowel necessitates resection and primary anastomosis with repair of mesenteric defect. The postoperative course was uneventful. Acute intestinal obstruction in the absence of an external hernia and with nw history of an internal hernia,
especially
if
the patient has a history of chromic intermittent abdominal distress
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