Preperitoneal herniation as a complication of tansabdominal preperitoneal patch plasty: a report of two cases

Abstract Background Preperitoneal herniation is a rare complication after transabdominal preperitoneal patch plasty (TAPP) and may be caused by inadequate peritoneal closure. We herein report two cases of postoperative small bowel obstruction due to preperitoneal herniation through a disrupted peritoneum. Case presentation Two men in their 70s were admitted to our center because of small bowel obstruction after TAPP. After examinations and unsuccessful conservative treatment, emergency laparoscopic exploration was performed. Preperitoneal herniation through the disrupted peritoneum was found. The herniated small bowel was reduced and the peritoneum was properly reclosed. The patients recovered and were discharged with normal bowel function. Conclusions Inadequate peritoneal closure may cause preperitoneal herniation and lead to postoperative small bowel obstruction and even death. Hernia surgeons can avoid this complication by improving their suture technique and paying attention to the procedure details.

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2. How conservative can one get with postoperative small bowel obstruction?

The American Journal of Surgery ◽

10.1016/0002-9610(92)90572-9 ◽

1992 ◽

Vol 163 (6) ◽

pp. 623

Author(s):

D. Seror ◽

E. Feigin ◽

A. Szold ◽

T. Allweis ◽

M. Carmon ◽

...

Keyword(s):

Small Bowel ◽

Small Bowel Obstruction ◽

Bowel Obstruction ◽

Postoperative Small Bowel Obstruction

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Bowel obstruction and perforation secondary to barbed suture after minimally invasive inguinal hernia repair: report of two cases and literature review

Surgical Case Reports ◽

10.1186/s40792-021-01249-w ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Liming Wang ◽

Taku Maejima ◽

Susumu Fukahori ◽

Shoji Nishihara ◽

Daitaro Yoshikawa ◽

...

Keyword(s):

Small Intestine ◽

Inguinal Hernia ◽

Small Bowel ◽

Small Bowel Obstruction ◽

Bowel Obstruction ◽

Bowel Perforation ◽

Barbed Suture ◽

Small Bowel Perforation ◽

Peritoneal Closure ◽

Pubmed Database

Abstract Background Laparoscopic transabdominal preperitoneal patch (TAPP) is now commonly used in the repair of inguinal hernia. Barbed suture can be a fast and effective method of peritoneal closure. We report two rare cases of small bowel obstruction and perforation caused by barbed suture after TAPP. Cases Patient 1 is a 45-year-old man who underwent laparoscopic repair of a right inguinal hernia. Barbed suture was used to close the peritoneal defect. At 47 days after the operation, he was diagnosed with a small bowel obstruction caused by an elongated tail of the barbed suture. Emergency laparoscopic exploration was performed for removal of the embedded suture and detorsion of the volvulus. The second patient is a 50-year-old man who was admitted with a small bowel perforation one week after TAPP herniorrhaphy. Emergency exploration revealed that the tail of the barbed suture had pierced the small intestine, causing a tiny perforation. After cutting and releasing the redundant tail of the barbed suture, the serosal and muscular defect was closed with 2 absorbable single-knot sutures. Both patients have recovered well. Finally, we searched the PubMed database and reviewed the literature on the effectiveness and safety of barbed suture for TAPP. Conclusions Surgeons should understand the characteristics of barbed suture and master the technique of peritoneum closure during TAPP in order to reduce the risk of bowel obstruction and perforation.

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How conservatively can postoperative small bowel obstruction be treated?

The American Journal of Surgery ◽

10.1016/s0002-9610(05)80414-3 ◽

1993 ◽

Vol 165 (1) ◽

pp. 121-126 ◽

Cited By ~ 108

Author(s):

Dan Seror ◽

Elad Feigin ◽

Amir Szold ◽

Tanir M. Allweis ◽

Moshe Carmon ◽

...

Keyword(s):

Small Bowel ◽

Small Bowel Obstruction ◽

Bowel Obstruction ◽

Postoperative Small Bowel Obstruction

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563 A Rare Case of Small Bowel Obstruction Secondary to Peritoneal Encapsulation, Congenital Adhesional Band and Gallstone Ileus

British Journal of Surgery ◽

10.1093/bjs/znab259.300 ◽

2021 ◽

Vol 108 (Supplement_6) ◽

Author(s):

P Gungadin ◽

A Taib ◽

M Ahmed ◽

A Sultana

Keyword(s):

Small Bowel ◽

Small Bowel Obstruction ◽

Bowel Obstruction ◽

Unusual Case ◽

Gallstone Ileus ◽

Gall Stone ◽

Case Presentation ◽

Peritoneal Encapsulation ◽

History Of ◽

Gall Stone Ileus

Abstract Introduction Small bowel obstruction can be caused by multiple factors. We describe an unusual case of small bowel obstruction secondary to three rare factors: gallstone ileus, peritoneal encapsulation and congenital adhesional band. Case Presentation A seventy-nine-year-old male presented with a four-day history of obstipation and abdominal pain. CT abdomen pelvis revealed small bowel obstruction secondary to gallstone ileus. The patient was managed by laparotomy. The intraoperative findings revealed the presence of a congenital peritoneal encapsulation with an adhesional band and gallstone proximal to the ileo-caecal valve. Although there was some dusky small bowel, this recovered following the release of the band. Discussion Peritoneal Encapsulation is a rare congenital pathology resulting in the formation of an accessory peritoneal membrane around the small bowel. This condition is asymptomatic and rarely presents as small bowel obstruction. The diagnosis is often made at laparotomy. There are less than 60 cases reported in literature. Gallstone ileus is another rare entity caused by an inflamed gallbladder adhering to part of the bowel resulting in a fistula. Conclusions The rarity of these conditions mean that they are poorly understood. A combination of this triad of gall stone ileus in the presence of peritoneal encapsulation and congenital band has not been reported before. Knowledge of this would raise awareness, facilitate diagnosis and management of patients.

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Sclerosing Mesenteritis: A Rare Cause of Small Bowel Obstruction

Case Reports in Gastroenterology ◽

10.1159/000444413 ◽

2016 ◽

Vol 10 (1) ◽

pp. 67-71 ◽

Cited By ~ 4

Author(s):

Glenn Harvin ◽

Adam Graham

Keyword(s):

Small Bowel ◽

Small Bowel Obstruction ◽

Bowel Obstruction ◽

Bowel Resection ◽

Rare Complication ◽

Small Bowel Resection ◽

Sclerosing Mesenteritis ◽

Exact Etiology ◽

Resected Tissue ◽

Uncommon Condition

Sclerosing mesenteritis falls within a spectrum of primary idiopathic inflammatory and fibrotic processes that affect the mesentery. The exact etiology has not been determined, although the following associations have been noted: abdominal surgery, trauma, autoimmunity, paraneoplastic syndrome, ischemia and infection. Progression of sclerosing mesentritis can lead to bowel obstruction, a rare complication of this uncommon condition. We report a case of a 66-year-old female with abdominal pain who was noted to have a small bowel obstruction requiring laparotomy and a partial small bowel resection. The pathology of the resected tissue was consistent with sclerosing mesenteritis, a rare cause of a small bowel obstruction. Sclerosing mesenteritis has variable rates of progression, and there is no consensus regarding the optimal treatment. Physicians should consider sclerosing mesenteritis in the differential diagnosis of a small bowel obstruction.

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