Transmesenteric small bowel herniation causing intestinal obstruction following laparoscopic transperitoneal nephrectomy

Mohammed M. Hajhamad, Reynu Rajan, Nik Ritza Kosai Nik Mahmood, Badrulhisham Bahadzor

Research output: Contribution to journalArticle

Abstract

In the field of urology, laparoscopic nephrectomy has become the most frequently performed laparoscopic procedure. Bowel-related complications are rare and predominantly ileus related. In addition, intestinal obstruction (IO) secondary to internal herniation is rarely documented. According to our review of the literature, only a few such cases have been reported worldwide. Here, we report a 72-year-old man with painless macroscopic hematuria. He was diagnosed with left renal cell carcinoma, and he subsequently underwent laparoscopic transperitoneal left radical nephrectomy. Two days following surgery, he developed acute IO. Computed tomography of the abdomen revealed dilated small bowel loops. Laparotomy revealed small bowel herniation via a sigmoid colon mesenteric defect. After reduction of the herniated bowel loops, the defect was closed using absorbable sutures. The patient was discharged 6 days later. Internal herniation is a rare cause of IO, accounting for <3% of cases. It occurs due to creation of a transmesocolic defect during mobilization of the left colon, facilitating small bowel migration into a potential space in the renal bed. Generally, a meticulous dissection technique is used in such cases to avoid any unnecessary mesenteric tears and repair the evident mesenteric defects observed during the intraoperative period.

Original languageEnglish
Pages (from-to)161-164
Number of pages4
JournalFormosan Journal of Surgery
Volume49
Issue number4
DOIs
Publication statusPublished - 1 Aug 2016

Fingerprint

Intestinal Obstruction
Nephrectomy
Intraoperative Period
Ileus
Urology
Sigmoid Colon
Hematuria
Tears
Ambulatory Surgical Procedures
Renal Cell Carcinoma
Abdomen
Laparotomy
Sutures
Dissection
Colon
Tomography
Kidney

Keywords

  • internal herniation
  • intestinal obstruction
  • laparoscopic nephrectomy
  • mesenteric defect
  • renal cell carcinoma

ASJC Scopus subject areas

  • Surgery

Cite this

Transmesenteric small bowel herniation causing intestinal obstruction following laparoscopic transperitoneal nephrectomy. / Hajhamad, Mohammed M.; Rajan, Reynu; Nik Mahmood, Nik Ritza Kosai; Bahadzor, Badrulhisham.

In: Formosan Journal of Surgery, Vol. 49, No. 4, 01.08.2016, p. 161-164.

Research output: Contribution to journalArticle

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