Transmesenteric Internal Herniation Leading to Small Bowel Obstruction Postlaparoscopic Radical NephrectomyReport as inadecuate




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Case Reports in Surgery - Volume 2017 2017, Article ID 5128246, 4 pages - https:-doi.org-10.1155-2017-5128246

Case ReportTan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433

Correspondence should be addressed to G. A. Cuthbert

Received 15 February 2017; Accepted 21 March 2017; Published 30 March 2017

Academic Editor: Robert Stein

Copyright © 2017 G. A. Cuthbert and L. T. Teo. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Internal herniation following laparoscopic surgery is rare. We present a case of small bowel obstruction secondary to internal herniation in a 76-year-old male patient. Presentation was on postoperative day 28 following transperitoneal laparoscopic radical left nephrectomy for suspected renal carcinoma. The herniation was through a defect in the large bowel mesentery identified at exploratory laparotomy. To date, 10 cases of internal herniation following laparoscopic nephrectomy have been described in the literature. Two cases were managed laparoscopically and the remainder by laparotomy. One case required resection of an ischaemic portion small bowel and the remainder were managed by reduction of the hernia and closure of the defect. Internal herniation is rare but carries significant morbidity. It must be considered in cases presenting with obstructive symptoms after laparoscopic nephrectomy. Early CT scanning and prompt surgical management are hallmarks of best management.





Author: G. A. Cuthbert and L. T. Teo

Source: https://www.hindawi.com/



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