Recurrent wound dehiscence and small bowel herniation following Caesarean section in a woman with hidradenitis suppurativa

Abstract Background Bowel herniation through a defect in the broad ligament of the uterus is a rare disease and few cases of recurrence have been reported. We report herein a recurrence case of a patient with broad ligament hernia (BLH), along with a review of the literature. Case presentation A 53-year-old woman complaining of abdominal pain was transported to our hospital. She had a history of laparotomy for small-bowel obstruction associated with hernia in the broad ligament of the uterus 10 years ago at a local hospital. Abdominal pelvic contrast-enhanced computed tomography revealed that the mesentery of the dilated bowels converged at a thick band in the pelvis, suggesting closed loop obstruction of the small bowel. The patient underwent urgent laparotomy and was diagnosed with bowel herniation through an opening in the broad ligament of the uterus on the right side, which was ipsilateral with the previous surgery. The hernia orifice was widened by incision and incarcerated bowel segments were released and preserved because ischemia was reversible. The membranous defect of BLH was closed by suture with braded silk strings. Conclusions Although BLH is a rare disease, patients face a significant risk of disease recurrence. Nonabsorbable suture may be advisable for closure of the hernia orifice in BLH.

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Laparoscopic repair of a small bowel herniation through a broad ligament defect

Journal of Minimal Access Surgery ◽

10.4103/0972-9941.134887 ◽

2014 ◽

Vol 10 (3) ◽

pp. 166

Author(s):

Agustin Buero ◽

EzequielA. Silberman ◽

Pablo Medina ◽

MatiasE. Morra ◽

DiegoJ. Bogetti ◽

...

Keyword(s):

Small Bowel ◽

Laparoscopic Repair ◽

Broad Ligament ◽

Bowel Herniation ◽

Broad Ligament Defect

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Acute gastric outlet obstruction secondary to exclusive paraoesophageal small bowel herniation: a case report

Acta Chirurgica Belgica ◽

10.1080/00015458.2017.1316620 ◽

2017 ◽

Vol 118 (2) ◽

pp. 129-131

Author(s):

Jean-Charles de Schoutheete ◽

Alex M. Reece-Smith ◽

Saj A. Wajed

Keyword(s):

Case Report ◽

Small Bowel ◽

Gastric Outlet Obstruction ◽

Outlet Obstruction ◽

Bowel Herniation

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Small bowel incarceration as a complication of port site drainage following laparoscopic hysterectomy

Vojnosanitetski pregled ◽

10.2298/vsp1501057l ◽

2015 ◽

Vol 72 (1) ◽

pp. 57-59

Author(s):

Sasa Ljustina ◽

Radmila Sparic ◽

Sanja Novakovic ◽

Snezana Buzadzic

Keyword(s):

Small Bowel ◽

Open Surgery ◽

Multislice Computed Tomography ◽

Laparoscopic Hysterectomy ◽

Postoperative Recovery ◽

Surgical Drainage ◽

Ileal Loop ◽

Atypical Endometrial Hyperplasia ◽

Small Bowel Incarceration ◽

Bowel Herniation

Introduction. Indication for surgical drainage may be prophylactic or therapeutic. However, surgical drains may cause complications. These complications can arise either following laparoscopic or open surgery. One of the rare complications resulting from drainage includes herniation of abdominal viscera at the drain site. The most common herniated abdominal organ is the small bowel. Case report. A 75-year-old woman underwent laparoscopic hysterectomy for atypical endometrial hyperplasia. After the operation, she developed small bowel herniation in the abdominal wall at the drain site, which was confirmed by multislice computed tomography. The patient underwent emergency relaparotomy that identified drain site incarceration of an ileal loop. Following resection of the incarcerated bowel, her postoperative recovery was uneventful. Conclusion. This case presents rare causative mechanism of intestinal obstruction. The possible occurrence of hernias following surgical drainage must be kept in mind.

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Experience of serious intestinal hemorrhage and perforation in small bowel lymphoma: a case report

Korean Journal of Clinical Oncology ◽

10.14216/kjco.21020 ◽

2021 ◽

Vol 17 (2) ◽

pp. 126-130

Author(s):

Seo Ree Kim ◽

Sang Hoon Chun ◽

Jong Youl Jin ◽

Tae-Geun Gweon ◽

Hayemin Lee ◽

...

Keyword(s):

Small Bowel ◽

B Cell ◽

Cell Lymphoma ◽

Wound Dehiscence ◽

B Cell Lymphoma ◽

Distal Ileum ◽

Intestinal Bleeding ◽

Urgent Surgery ◽

Large B Cell Lymphoma ◽

Large B Cell

There have been several reports of complications of small bowel lymphoma, such as bleeding, obstruction, and perforation, often require emergency surgery. It is hardly showed complications of bleeding and wound dehiscence for diffuse large B cell lymphoma with distal ileum involvement, which needed urgent surgery and medical management. A 65-year-old man with diffuse large B-cell lymphoma with distal ileum involvement experienced both intestinal bleeding and perforation during the course of treatment. As the patient was diagnosed with stage III disease, resection before chemotherapy was not considered due to the resulting delay in chemotherapy, which necessitated sufficient tissue healing. Chemotherapy is important when treating small bowel lymphoma, complications such as bleeding and perforation should always be considered for the treatment of small bowel lymphoma, and surgery is necessary in this situation. After surgery of the small bowel, subsequent chemotherapy could cause wound dehiscence and perforation; therefore, adequate recovery time should be given before chemotherapy.

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Transmurally migrated gossypiboma rarely posing as surgical site infection: a case report and review of literature

International Surgery Journal ◽

10.18203/2349-2902.isj20204168 ◽

2020 ◽

Vol 7 (10) ◽

pp. 3500

Author(s):

Amrita Gaurav ◽

Juhi Mishra ◽

Om Kumari ◽

Kavita Khoiwal ◽

Farhanul Huda ◽

...

Keyword(s):

Caesarean Section ◽

Surgical Site Infection ◽

Sigmoid Colon ◽

Primary Repair ◽

Wound Dehiscence ◽

Colon Perforation ◽

Site Infection ◽

Surgical Sponge ◽

Ileal Loop ◽

Sigmoid Colon Perforation

The term gossypiboma is used to describe a retained surgical sponge or gauge after surgery. The clinical features range from being asymptomatic to frank bowel obstruction, perforation and peritonitis. Radiological modalities also do not provide a definite diagnosis. We report a case of a 30-year-old lady who presented to the emergency room with recurrent surgical site infection. She had a history of caesarean section 5 months ago. Following the caesarean section, she developed superficial wound dehiscence which was re-sutured. At the present facility, the lady underwent Computed tomography (CT) scan and was suspected to have a foreign body around the gut. She was planned for an exploratory laparotomy. Upon laparotomy, a large thick-walled ileal loop with some unusual intra luminal mass was found. Dense adhesions were present between the ileal loop and sigmoid colon. Adhesiolysis led to an iatrogenic sigmoid colon perforation, around 2 cm length. On incision over the ileal loop, surgical sponge was retrieved. Ileal loop was resected along with perforated site with end-to-end ileo-ileal anastomosis was done. Primary repair of sigmoid colon perforation was done. Patient was stable in postoperative period. Although rare, gossypiboma should be kept in mind as a differential diagnosis in postoperative cases presenting with recurrent surgical site infection.

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COMPARISON OF OUTCOME OF SUTURE MATERIALS POYGLACTIN 910 & POLYAMIDE MONOFILAMENT AS SUBCUTICULAR STITCHES IN CAESAREAN SECTION.

10.36106/8517639 ◽

2021 ◽

pp. 77-79

Author(s):

Hari Charan Ray ◽

Himadri Nayek ◽

Jonge Lollen ◽

Sankar Nath Mitra ◽

Debarshi Jana

Keyword(s):

Caesarean Section ◽

Family Health ◽

Wound Dehiscence ◽

Population Level ◽

Obstetrics And Gynecology ◽

P Value ◽

Suture Materials ◽

Eligibility Criteria ◽

Medical College ◽

The Usa

INTRODUCTION:Caesarean delivery rate rose from 4.5 percent in 1970 to 32.9 percent in 2009. And then the rate has trended slightly downward, and it was 32 percent in 2015 in the USA. More than 85 percent of these operations are performed only for four reasons- prior caesarean delivery, dystocia, fetal jeopardy, or abnormal fetal presentation. As per the latest data (National Family Health Survey 2015-16 (NFHS-4), the caesarean rates at population level in India seems to be 17.2%. In 1985 WHO stated: ―There is no justication for any region to have Caesarean section rates higher than 10-15%. AIMS AND OBJECTIVES:The efcacy of two suture materials polyglactin 910 (Vicryl 2.0) and polyamide monolament (Ethilon 2.0) in terms of pain, tenderness, swelling, induration, discharge, cosmesis and wound healing, suture materials with least complications. MATERIALS AND METHODS:This was a prospective, observational, comparative study conducted in the Department of Obstetrics and Gynecology, in a tertiary medical college in Paschim Medinipur, for 18 months after getting approval from the Institutional Ethical Committee. 18 months; 1st April 2019 to 30th September 2020. Randomly selected term pregnant women admitted in the Department Of Obstetrics and Gynecology, Midnapore Medical College and Hospital during the study period and fullling the eligibility criteria (according to inclusion and exclusion criteria). RESULTS AND ANALYSIS:It is clear that the parameters, pain and tenderness (p value = 0.3710), swelling and induration (p value = 1) and wound dehiscence (p value =0) in both the groups are statistically insignicant and the other parameters are signicant in both the groups; discomfort (p value = 0.0114) and wound dehiscence (p value = 0.0254347). SUMMARY & CONCLUSION: Multilament sutures also induce a more intense inammatory response and contribute to larger knot volumes than monolaments of equal sizes. Multilament sutures demonstrate enhanced capillarity with a resultant increase in the transport and spread of microorganisms. There are multiple factors which cause surgical site complications that have not been analyzed in this study and need an additional evaluation in further studies and there is lack of previous research studies on the same topi

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