scholarly journals Bowel Obstruction and Peritoneal Dialysis: A Case Report of a Patient with Complications from a Broad Ligament Hernia

2016 ◽  
Vol 9 ◽  
pp. CCRep.S40059 ◽  
Author(s):  
Naoko Otani-Takei ◽  
Tetsu Akimoto ◽  
Ai Sadatomo ◽  
Osamu Saito ◽  
Shigeaki Muto ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Abdominal Wall ◽  
Bowel Obstruction ◽  
Correct Diagnosis ◽  
Broad Ligament ◽  
Exploratory Laparotomy ◽  
Peritoneal Dialysis Patient ◽  
Internal Hernias ◽  
Abdominal Hernias ◽  
Initial Work

Abdominal hernias are a common cause of bowel obstruction. The major types of abdominal hernias are external or abdominal wall hernias, which occur at areas of congenital or acquired weakness in the abdominal wall. An alternative entity is internal hernias, which are characterized by a protrusion of viscera through the peritoneum or mesentery. We herein present the case of a female peritoneal dialysis patient with bowel obstruction due to an internal hernia. Although an initial work-up did not lead to a correct diagnosis, an exploratory laparotomy revealed that she had intestinal herniation due to a defect in the broad ligament of the uterus, which was promptly corrected by surgery. The concerns about the perioperative dialytic management as well as the diagnostic problems regarding the disease that arose in our experience with the present patient are also discussed.

scholarly journals THREE CASES OF BOWEL OBSTRUCTION BY BROAD LIGAMENT HERNIA

2021 ◽  
Vol 108 (Supplement_3) ◽  
Author(s):  
M Soto Dopazo ◽  
E Pérez Prudencio ◽  
A Arango Bravo ◽  
C Nuño Iglesias ◽  
C Mateos Palacios ◽  
...  
Keyword(s):  
Small Bowel ◽  
Bowel Obstruction ◽  
Broad Ligament ◽  
Intestinal Resection ◽  
Laparoscopic Approach ◽  
Exploratory Laparotomy ◽  
X Rays ◽  
Intestinal Necrosis ◽  
Urgent Surgery ◽  
Internal Hernias

Abstract INTRODUCTION Internal hernias caused by broad ligament defects are an infrequent cause of bowel obstruction. These defects may be congenital or acquired mainly by gynecological antecedents. Small bowel is the most common affected and the diagnosis is difficult due to nonspecific symptoms and absences of characteristic radiological signs. MATERIAL AND METHODS We report the cases of three women aged from 43 to 56 years old, who came to the emergency with abdominal pain, vomiting and bloating of hours duration. One patient has a history of laparoscopic appendectomy, the rest of them with no surgical history. In all of the cases, x-rays showed dilatation of small bowel loops and air-fluid levels and the abdominal TC revealed a generalized distention of bowel loops with transition point in the terminal ileum with no identifiable cause compatible with small bowel obstruction. RESULTS We decided to perform an urgent surgery with an exploratory laparotomy in one case and the rest by laparoscopic approach, finding an internal hernia occasioned by incarceration of small bowel through a broad ligament defect. In all cases, the hernia content was liberated without evidence of ischemia with no need for intestinal resection, and the defect was closed. All patients had a favourable postoperative course without complications. DISCUSSION Broad ligament defects are a rare cause of internal hernias. These are difficult to diagnose clinically as well as radiologically for an absence of characteristic signs. A high level of clinical suspicion allows early diagnosis and the treatment should be performed as soon as possible to reduce the chances of intestinal necrosis.

scholarly journals Small Bowel Obstruction by Broad Ligament Hernia: Three Case Reports, Management and Outcomes

2019 ◽  
Vol 32 (3) ◽  
pp. 240
Author(s):  
Manuela Graça Fernandes ◽  
Ana Rita Mateus Loureiro ◽  
Maria João Diogo Obrist ◽  
César Prudente
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Case Reports ◽  
Broad Ligament ◽  
Exploratory Laparotomy ◽  
Anatomical Location ◽  
Internal Hernias ◽  
Surgical History ◽  
Broad Ligament Defect

Internal hernias are a rare cause of bowel obstruction (1%) and can be caused by broad ligament defects in 4% to 7% of the cases. These defects may be congenital or acquired and are classified according to its anatomical location. This paper reports three cases of small bowel obstruction by broad ligament hernia. The patients, three women aged from 35 to 51 years old, were admitted to the emergency department with small bowel obstruction. An exploratory laparotomy was performed during which an internal hernia through a broad ligament defect was identified. In all cases the hernia content was reduced and the defect closed. One of the patients required a segmental enterectomy. All patients had a favorable outcome. This paper aims to raise awareness about the broad ligament hernia as a cause of bowel obstruction, namely in middle-aged women with no surgical history.

scholarly journals Delayed bowel perforation after instilling over warmed peritoneal dialysate

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Xueli Lai ◽  
Mingming Nie ◽  
Xiaodong Xu ◽  
Yuanjie Chen ◽  
Zhiyong Guo
Keyword(s):  
Peritoneal Dialysis ◽  
Bowel Perforation ◽  
Exploratory Laparotomy ◽  
Peritoneal Dialysis Patient ◽  
Case Presentation ◽  
Abdominal Organs ◽  
Home Based ◽  
Dialysis Solution ◽  
Stage Renal Disease ◽  
End Stage

Abstract Background Peritoneal dialysis (PD) is a safe and home-based treatment for end-stage renal disease (ESRD) patients. The direct thermal damage of abdominal organs is very rare. Case presentation We report a peritoneal dialysis patient presented abdominal pain and feculent effluent 3 weeks after he instilled hot dialysis solution. In spite of emergency exploratory laparotomy and active treatment, the patient died of septic shock. Biopsy revealed necrosis and perforation of the intestines. Conclusions Delayed bowel perforation by hot fluid is very rare. Standardized performance is of the first importance for peritoneal dialysis patients.

scholarly journals Internal hernia - a rare cause of small bowel obstruction: a case report

2016 ◽  
Vol 4 (1) ◽  
pp. 427 ◽  
Author(s):  
Samir U. Rambhia ◽  
Premjeet Madhukar
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Internal Hernia ◽  
Previous History ◽  
Exploratory Laparotomy ◽  
Internal Hernias ◽  
Post Surgery ◽  
History Of ◽  
Acute Small Bowel Obstruction

Internal hernia means a protrusion into pouches or openings in the peritoneum or mesentry in contrast to the hernias through defects in the retaining walls of the abdomen. Internal hernias are of many varieties with different classifications and can be congenital or acquired post-surgery. We present a case of a 55 year old female who presented with symptoms of acute small bowel obstruction with previous history of exploratory laparotomy 20 years back for reasons not known to her. Routine blood investigations, chest and abdomen skiagram and a CECT abdomen were performed (which gave no significant clue to diagnosis) and after a failed conservative trial patient was taken for exploration. Intra operatively a gangrenous loop of small bowel was found herniating through a band between the small bowel mesentry and the sigmoid mesocolon, forming a closed loop obstruction. Resection anastomosis of the gangrenous segment along with band transection was performed. The post-operative course was uneventful. Internal herniation as a cause of bowel obstruction should always be kept in mind as a differential.

Recurrence of Abdominal Wall Hernias Due to Failure of Mesh Repair in a Peritoneal Dialysis Patient

1997 ◽  
Vol 17 (1) ◽  
pp. 89-90 ◽  
Author(s):  
Georgi Abraham ◽  
Manohar N. Nallathambi ◽  
Shanmukham Bhaskaran ◽  
Lakshminarayanan Srinivasan
Keyword(s):  
Peritoneal Dialysis ◽  
Abdominal Wall ◽  
Dialysis Patient ◽  
Mesh Repair ◽  
Peritoneal Dialysis Patient

scholarly journals Strangulated internal hernia due to defect in broad ligament: a case report

2020 ◽  
Vol 2020 (11) ◽  
Author(s):  
Nicole Reyes ◽  
Lauren E Smith ◽  
David Bruce
Keyword(s):  
Case Report ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Broad Ligament ◽  
Disease Process ◽  
The United States ◽  
Lower Percentage ◽  
Common Disease ◽  
Internal Hernias

Abstract Small bowel obstruction is a relatively common disease process accounting for up to 16 percent of surgical admissions and more than 300,000 operations annually in the United States. Approximately 5–8 percent of small bowel obstructions can be attributed to internal hernias. A slightly lower percentage, roughly 4–7 percent, of these internal hernias are noted to originate from a defect in the broad ligament of the uterus. A majority of broad ligaments defects causing a small bowel obstruction are not diagnosed preoperatively due to the equivocal imaging findings as well as the infrequency of this etiology. To date, there are very few case reports describing this disease process. This case report describes a 70-year-old female who was found to have a defect in her broad ligament causing a small bowel obstruction leading to subsequent strangulated bowel.

scholarly journals Epithelioid trophoblastic tumor coexisting with choriocarcinoma around an abdominal wall cesarean scar: a case report and review of the literature

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Chunfeng Yang ◽  
Jianqi Li ◽  
Yuanyuan Zhang ◽  
Hanzhen Xiong ◽  
Xiujie Sheng
Keyword(s):  
Abdominal Wall ◽  
Chorionic Gonadotropin ◽  
Human Chorionic Gonadotropin ◽  
Unknown Origin ◽  
Exploratory Laparotomy ◽  
Cesarean Scar ◽  
Trophoblastic Tumor ◽  
Epithelioid Trophoblastic Tumor ◽  
Trophoblastic Tumors ◽  
Wall Lesion

Abstract Background Mixed gestational trophoblastic neoplasms are extremely rare and comprise a group of fetal trophoblastic tumors including choriocarcinomas, epithelioid trophoblastic tumors, and placental site trophoblastic tumors. We present a case of a patient with extrauterine mixed gestational trophoblastic neoplasm adjacent to the abdominal wall cesarean scar. On the basis of a literature review, this type of case has never been reported before due to the unique lesion location and low incidence. Case presentation Our patient was a 39-year-old Chinese woman who had a history of two cesarean sections and one miscarriage. She had a recurrent anterior abdominal wall mass around her cesarean scar, and the mass was initially suspected of being choriocarcinoma of unknown origin. The patient had concomitant negative or mildly increased serum β-human chorionic gonadotropin at follow-up and no abnormal vaginal bleeding or abdominal pain. However, she underwent local excision twice and had two courses of chemotherapy with an etoposide and cisplatin regimen. She finally opted for exploratory laparotomy with abdominal wall lesion removal, subtotal hysterectomy, bilateral salpingectomy, and left ovarian cyst resection, which showed the abdominal wall lesion, whose components were revealed by microscopy and immunohistochemical staining to be approximately 90% epithelioid trophoblastic tumors and 10% choriocarcinomas from a solely extrauterine mixed gestational trophoblastic neoplasm around an abdominal wall cesarean scar. Conclusions It is worth noting whether epithelioid trophoblastic tumor exists in the setting of persistent positive low-level β-human chorionic gonadotropin. More studies are required to provide mechanistic insights into these mixed gestational trophoblastic neoplasms.

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