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doi:10.22028/D291-33711
Titel: | Jejunal obstruction due to rare internal hernia between skeletonized external iliac artery and vein as late complication of laparoscopic hysterectomy with pelvic lymphadenectomy-case report and review of literature |
VerfasserIn: | Frenzel, Felix Hollaender, Sebastian Fries, Peter Stroeder, Russalina Stroeder, Jonas |
Sprache: | Englisch |
Titel: | Archives of Gynecology and Obstetrics |
Bandnummer: | 302 |
Heft: | 5 |
Seiten: | 1075–1080 |
Verlag/Plattform: | Springer Nature |
Erscheinungsjahr: | 2020 |
Freie Schlagwörter: | Internal hernia Lymphadenectomy Small bowel obstruction Iliac vessels Case report |
DDC-Sachgruppe: | 610 Medizin, Gesundheit |
Dokumenttyp: | Journalartikel / Zeitschriftenartikel |
Abstract: | Background Internal herniation of small intestine in the lesser pelvis alongside iliac vasculature is a rare occurrence. Skeletonization of iliac vessels during pelvic lymph node dissection (LND), as part of surgical staging or treatment of patients with uterine, ovarian or urogenital cancer, is a strict prerequisite for orifce formation. Case presentation A 68-year-old woman presented at the emergency department with complaints of constipation for the last 3 days and acute-onset abdominal pain, nausea and vomiting since few hours. She had a history of laparoscopic hysterectomy, bilateral salpingo-oophorectomy and para-aortic and pelvic LND 7 years ago. A distended abdomen with difuse tenderness on palpation was noted. A CT scan demonstrated bowel obstruction secondary to an incarcerated hernia underneath an elongated right external iliac artery. During an emergency exploratory laparotomy, the incarcerated bowel was reduced and the hernial orifce closed with a running suture. The patient had an uneventful postoperative period and was discharged on the ffth postoperative day. Discussion This rare internal hernia can manifest with non-specifc symptoms of small bowel obstruction at any given point after index surgery, sometimes even after several years free of complaints. Contrast-enhanced computed tomography is the method of choice for fast and reliable diagnosis and helps in planning the necessary emergency laparotomy. Conclusion This life-threatening complication adds to the current controversy of pelvic and para-aortic lymphadenectomy in patients with endometrial cancer. Primary closure of peritoneal defects should be considered to potentially prevent internal hernias, especially when elongated iliac vessels are present. |
DOI der Erstveröffentlichung: | 10.1007/s00404-020-05724-x |
Link zu diesem Datensatz: | urn:nbn:de:bsz:291--ds-337110 hdl:20.500.11880/31029 http://dx.doi.org/10.22028/D291-33711 |
ISSN: | 1432-0711 0932-0067 |
Datum des Eintrags: | 31-Mär-2021 |
Bezeichnung des in Beziehung stehenden Objekts: | Electronic supplementary material |
In Beziehung stehendes Objekt: | https://link.springer.com/article/10.1007/s00404-020-05724-x#Sec6 |
Fakultät: | M - Medizinische Fakultät |
Fachrichtung: | M - Radiologie |
Professur: | M - Keiner Professur zugeordnet |
Sammlung: | SciDok - Der Wissenschaftsserver der Universität des Saarlandes |
Dateien zu diesem Datensatz:
Datei | Beschreibung | Größe | Format | |
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Frenzel2020_Article_JejunalObstructionDueToRareInt.pdf | 640,67 kB | Adobe PDF | Öffnen/Anzeigen |
Diese Ressource wurde unter folgender Copyright-Bestimmung veröffentlicht: Lizenz von Creative Commons