Discussion :
A supravesical hernia (SH) is a rare abdominal wall hernia that is defined by the protrusion of abdominal viscera through the supravesical fossa (1). There are two variants of supravesical hernias: an external form caused by the laxity of the vesical preperitoneal tissue with a hernia sac usually that protrudes through the anterior abdominal wall, and an internal one with a growing hernia sac from back to front and above the bladder in a sagittal paramedian direction (2). External supravesical hernia is more common than internal supravesical hernia, and it is difficult to make a differential diagnosis from inguinal hernia. The great majority of internal supravesical hernias occupy a prevesical location in the space of Retzius. These supravesical hernias occur predominantly in male adults. It has been suggested that the bladder filling in males causes an anterosuperior enlargement that traps intestines in supravesicular diverticula when present, while in the female, the distention of the bladder occurs laterally and forces supravesical diverticular contents upward and outward (3). The diagnosis of this rare cause of intestinal obstruction is usually made only at operation. But, the knowlege of the anatomy of the supravesical fossa may allow preoperative diagnosis by CT, as demonstrated the report by Sasaya et al (4).
Their treatment is surgical and its objective is to reduce the herniated viscera and then suture the orifice. The excision of the hernial sac is an unnecessary procedure and as some authors have reported, these procedures can be done via laparoscopy (5).a