To investigate the clinical features and surgical management of intestinal obstruction caused by internal hernia without history of abdominal surgery, and whether laparoscopic exploration has advantages in the diagnosis and treatment of this disease.

The clinical features of 20 cases of internal abdominal hernia without abdominal operation history in Beijing Chuiyangliu hospital were retrospectively analyzed. 10 cases were diagnosed and treated bylaparotomy in the early stage and 10 cases by laparoscopy in the later stage. A comparative analysis was conducted between the two groups.

This disease was characterized by the majority of intestinal obstruction as the main clinical manifestations, but abdominal distension was often light or late, whereas intestinal strangulation and necrosis appeared relatively early. This disease progressed dangerously, and the preoperative diagnosis rate of CT examination was not high, which put forward the test for the early diagnosis and timely surgical treatment of clinicians. Preoperative 5 cases were confirmed by CT, and the remaining 15 cases were confirmed by intraoperative exploration. Among them, 6 cases underwent intestinal resection and anastomosis, and 14 cases underwent surgical reduction. One patient died after the operation, and all the other patients recovered. There were statistically significant differences between the laparoscopic group and the control group in terms of the operation time, intraoperative blood loss, postoperative exhaust time, out-of-bed activity time, hospital stay time and postoperative complications.

There is no specific clinical manifestation of intestinal obstruction due to internal hernia with no history of abdominal surgery. To improve clinical surgeons' understanding of this disease, early abdominal exploration is the key to improve the curative effect and save the patients' lives. The application of laparoscope in this kind of disease is safe and effective, can make clear diagnosis. Minimally invasive surgery can be accomplished with full laparoscopy or laparoscopic-assisted surgery.