scholarly journals Internal hernia caused by a free intraperitoneal staple after laparoscopic appendectomy

2018 ◽  
Vol 4 (1) ◽  
pp. 14 ◽  
Author(s):  
Lisa M. Angotti ◽  
Christopher Decker ◽  
Brittany Pahwa ◽  
Carl Rosati ◽  
Todd Beyer
Keyword(s):  
Small Bowel ◽  
Bowel Obstruction ◽  
Laparoscopic Appendectomy ◽  
Internal Hernia ◽  
Closed Loop ◽  
Ease Of Use ◽  
Lower Quadrant ◽  
Transition Points ◽  
The Veil ◽  
The Right

Background: Laparoscopic appendectomy is the gold standard for treatment of appendicitis. Stapled closure of the appendiceal stump is commonly performed and has several advantages. Few prior cases have demonstrated complications from free staples left within the abdomen after the stapler has been fired.Case report: A 29-year-old female underwent laparoscopic appendectomy for acute uncomplicated appendicitis during which the appendix and mesoappendix were divided using laparoscopic gastrointestinal anastomosis (GIA) staplers. Her initial recovery was uncomplicated. She returned on postoperative day 17 with sharp mid-abdominal pain, obstipation, and emesis. Her abdomen was distended, and she had a mild leukocytosis. Computed tomography (CT) demonstrated twisted loops of dilated small bowel in the right lower quadrant with two transition points, suggestive of internal hernia with closed loop bowel obstruction. Diagnostic laparoscopy was performed through the three prior appendectomy incisions. An adhesion between the Veil of Treves and the mesentery of the ileum caused by a solitary free closed staple, remote from the staple lines, had caused an internal hernia. The hernia was reduced, and the small bowel was noted to have early ischemic discoloration. The adhesion was lysed by removing the staple from both structures. The compromised loops of bowel began to show peristaltic movement and color returned to normal, and the procedure was concluded without resection. She was discharged home the following day.Conclusions: Gastrointestinal staplers are commonly used due to ease of use and low complication rate. It is not uncommon to leave free staples in the abdomen as retrieval can be difficult and time consuming. Our case is only the second in the literature reporting an internal hernia with closed loop bowel obstruction as a complication of retained staples. Choosing the most appropriate size staple load to reduce the number of extra staples, removing free staples, or the use of an endoloop can prevent potentially devastating complications.

scholarly journals Internal hernia and small bowel obstruction caused by a linear cutter staple at appendiceal stump following laparoscopic appendectomy

2014 ◽  
Vol 2014 (1) ◽  
pp. rjt114-rjt114 ◽  
Author(s):  
L. F. Petersen ◽  
M. C. Nally ◽  
A. Agos ◽  
K. Petty
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Laparoscopic Appendectomy ◽  
Internal Hernia ◽  
Appendiceal Stump ◽  
Linear Cutter

scholarly journals P-B03 Gastric Band Tubing Causing Small Bowel Obstruction

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Kashif Halim ◽  
Ana Lee ◽  
Stephen Odogwu ◽  
Amir Khan
Keyword(s):  
Gastric Bypass ◽  
Small Bowel ◽  
Gastric Banding ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Internal Hernia ◽  
Closed Loop ◽  
Gastric Band ◽  
Laparoscopic Gastric Banding ◽  
Gastric Bands

Abstract Background Laparoscopically adjustable gastric bands (LAGB) have been widely employed as a means of weight loss in bariatric surgery over the past two decades. Although now largely superseded by other bariatric surgical techniques, complications from gastric bands continue to be encountered in surgical practice. We report an unusual case of small bowel obstruction due to an internal hernia caused by gastric band tubing resulting in closed loop small bowel obstruction. This is  not  commonly encountered and emergency general surgeons need to have a high index of suspicion for this condition as a possible cause for small bowel obstruction. Methods A 40 year old male presented with abdominal pain, vomiting and failure to open bowels or pass flatus for nine days. Twelve years previously (2008) he had had Roux n Y gastric bypass (RYGB), followed by by laparoscopic gastric banding of the RYGB about two years later (2010) also in the private sector. He had a soft but distended abdomen, and empty rectum on rectal examination. CT scan abdomen reported as: Multiple loops of distended small bowel demonstrated. No air seen in rectum, indicative of small bowel obstruction. No pneumoperitoneum. There is dilatation of the mid and distal small bowel seen to an apparent transition point in the mid abdomen where a loop is noted associated with the tubing for the inflation device for the gastric band. This appears to be centred on the cause of obstruction and appears tied around the base of mesentery and may be creating a closed loop obstruction, by having created an internal hernia. This patient had an internal hernia around  loop of the gastric band tubing with resultant closed loop small bowel obstruction. The patient underwent diagnostic laparoscopy with ileo-caecal resection and primary anastomosis. He made successful recovery. Deflated gastric band remains in-situ. Results While small bowel obstruction is most commonly due to adhesions in individuals who have had previous laparotomy, it is important to bear in mind other causes such as internal hernias particularly in cases of those with history of previous gastric banding or Roux n Y gastric bypass. Early intervention may be necessary to reduce the  likelihood of bowel ischaemia and bowel resection. Laparoscopy is a useful tool in the management of small bowel obstruction. Keywords: gastric band, small bowel obstruction, closed loop, emergency surgery, laparoscopy Conclusions Connection tubing causing small bowel obstruction and colonic erosion as a rare complication after laparoscopic gastric banding: a case report. Liza BK Tan, Jimmy BY So, and Asim Shabbir - J Med Case Reports. 2012; 6: 9.  Acute small bowel obstruction due to the connecting tube of a gastric band. Federico Oppliger, M.D. Gonzalo Wiedmaier, M.D. Juan. Published April 07 2017. https://doi.org/10.1016/j.soard.2014.03.021 An unusual complication of gastric banding: recurrent small bowel obstruction caused by the connecting tube. M A Zappa, E Lattuada, E Mozzi, M Francese, I Antonini, S Radaelli, G Roviaro. Obes Surg . 2006 Jul;16(7):939-41.  doi: 10.1381/096089206777822250 Total small bowel herniation through the space between the connecting tube of gastric band and abdominal wall: A case report of a surgical emergency. Tarek Hashem, Soliman M Soliman, Sherif Wagih 2. Int J Surg Case Rep. 2017;30:66-68.  doi: 10.1016/j.ijscr.2016.11.021.  Epub 2016 Nov 17

scholarly journals Closed loop small bowel obstruction - internal hernia

2018 ◽  
Author(s):  
Michael Hartung
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Internal Hernia ◽  
Closed Loop

scholarly journals Closed loop small bowel obstruction due to paracaecal internal herniation: a lesson in rarity

2018 ◽  
Vol 11 (1) ◽  
pp. e227461 ◽  
Author(s):  
Richard Menezes ◽  
Ranjeet Kamble ◽  
Anagha Joshi ◽  
Kalpesh Chaudhari
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Closed Loop ◽  
Iliac Fossa ◽  
Tertiary Hospital ◽  
Postoperative Recovery ◽  
Abdominal Ct ◽  
Distended Bowel ◽  
The Right

A 40-year-old man presented to the emergency department of our tertiary hospital with acute abdominal pain since 1 day, which responded to conservative measures initially. On further investigation and abdominal CT, he was diagnosed with closed loop small bowel obstruction with an encapsulated lesion with small bowel loops within, in the right iliac fossa, which was initially missed. On exploration, the patient had a sac in the right iliac fossa (paracaecal incarcerated internal hernia) with distended bowel loops within, the sac was excised after reduction of the contents. Postoperative recovery was uneventful.

scholarly journals Transmesenteric hernia with closed-loop small bowel obstruction: A case report

2022 ◽  
pp. 103256
Author(s):  
Bibek Man Shrestha ◽  
Suraj Shrestha ◽  
Shiva Aryal ◽  
Susan Pradhan ◽  
Romi Dahal ◽  
...  
Keyword(s):  
Case Report ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Closed Loop ◽  
Transmesenteric Hernia

Small bowel obstruction secondary to internal hernia through a defect of the broad ligament: preoperative multi-detector CT diagnosis

2012 ◽  
Vol 37 (6) ◽  
pp. 1089-1091 ◽  
Author(s):  
Sergi Quiroga ◽  
Manuel Sarrias ◽  
José Luis Sánchez ◽  
Joaquín Rivero
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Internal Hernia ◽  
Broad Ligament ◽  
Ct Diagnosis

scholarly journals Intraluminal Meckel’s Duplication Cyst Causing Bowel Obstruction in an Infant: A Role for Laparotomy

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Mitchell R. Ladd ◽  
Alejandro V. Garcia ◽  
Derek B. Allison ◽  
Jeffrey R. Lukish
Keyword(s):  
Small Bowel ◽  
Bowel Obstruction ◽  
Ileocecal Valve ◽  
Signs And Symptoms ◽  
Duplication Cyst ◽  
Ectopic Gastric Mucosa ◽  
Lower Quadrant ◽  
Intraluminal Mass ◽  
Enteric Duplication ◽  
Right Lower Quadrant

This report describes a two-month-old girl who presented with signs and symptoms of a distal small bowel obstruction. She underwent an abdominal ultrasound that revealed a right lower quadrant cystic mass. A Technetium-99 scan revealed increased activity in the right lower quadrant consistent with a Meckel’s diverticulum. Following a nondiagnostic laparoscopic evaluation, a laparotomy was performed to allow direct palpation of the small bowel and colon. Direct palpation of the ileum revealed a soft intraluminal mass at the ileocecal valve. The child underwent an ileocecectomy and anastomosis incorporating the intraluminal mass. Pathologic analysis revealed an intraluminal enteric duplication cyst containing ectopic gastric mucosa. This case represents the first report of such an entity in an infant. A discussion of the diagnostic and therapeutic aspects of the case and enteric duplication cysts is provided.

scholarly journals A rare case of a closed loop obstruction due to epiploic appendage of the sigmoid colon

2020 ◽  
Vol 2020 (3) ◽  
Author(s):  
Rathin Gosavi ◽  
Ee Ban
Keyword(s):  
Small Bowel ◽  
Sigmoid Colon ◽  
Rare Case ◽  
Closed Loop ◽  
Primary Anastomosis ◽  
Uterine Cancer ◽  
Small Bowel Resection ◽  
Uneventful Recovery ◽  
Ischemic Bowel ◽  
The Right

Abstract An internal hernia is a protrusion of viscera through a congenital or acquired defect in the mesentery of peritoneum. They account for <0.9% of all small bowel obstructions [1] and ~4% of obstructions due to hernias [2]. We present a rare case of closed loop obstruction secondary to a band adhesion traversing the lower abdomen from a sigmoid colon appendage epiploicae to the right pelvic wall. A 82-year-old woman presented to the emergency department with nausea, vomiting and worsening right sided abdominal pain for 24 h, on the background of previous pelvic radiation and hysterectomy for uterine cancer. She was subsequently found to have a closed loop obstruction with 30 cm of ischemic bowel strangulated by a band adhesion from a sigmoid colon appendage epiploicae to the right abdominal wall. The patient underwent a successful small bowel resection with primary anastomosis and made an uneventful recovery.

Internal Hernia through a Congenital Peritoneal Defect in the Pouch of Douglas causing Small Bowel Obstruction

2020 ◽  
Vol 92 (3-4) ◽  
pp. 138-140
Author(s):  
C. Kounoudes ◽  
G. Veloudis ◽  
P. Katopodis ◽  
M. Malamas ◽  
Stavros Gourgiotis
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Internal Hernia ◽  
Pouch Of Douglas

scholarly journals Closed loop bowel obstruction secondary to left paraduodenal hernia (of Landzert)

2019 ◽  
Vol 12 (12) ◽  
pp. e232134
Author(s):  
Yeo Min Cho ◽  
Gamze Aksakal ◽  
Mohamed Ahmed Tawfik Ashour ◽  
Suzanne Moore
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Rare Case ◽  
Closed Loop ◽  
Flank Pain ◽  
Paraduodenal Hernia ◽  
Good Recovery ◽  
Left Colic Artery ◽  
Unusual Phenomenon

A 34-year-old man presented with acute severe left-sided abdominal and flank pain with associated postprandial nausea and vomiting. CT imaging revealed findings suspicious for a closed loop small bowel obstruction. Intraoperative findings were that of a left paraduodenal hernia (of Landzert) secondary to a mesenteric defect immediately posterior to the ascending branch of the left colic artery. The defect was closed via minilaparotomy. Unfortunately, his postoperative course was complicated by small bowel obstruction which required further laparotomy and adhesiolysis. The patient eventually made a good recovery. Here, we present a rare case of intestinal obstruction and discuss the aetiologies and management of this unusual phenomenon.

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