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Abdominal drain causing early small bowel obstruction after laparoscopic colectomy.

Chi-Ming Poon1, Heng-Tat Leong

  • 1Department of Surgery, North District Hospital, Sheung Shui, Hong Kong SAR, China. lamyn@ha.org.hk

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Summary

A rare complication after laparoscopic colectomy involved a silicon drain causing small bowel obstruction. Surgeons successfully treated the obstruction by removing the drain and repositioning the bowel mesentery.

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Area of Science:

  • Gastroenterology
  • Surgical Complications
  • Abdominal Surgery

Background:

  • Laparoscopic colectomy is a minimally invasive surgical procedure for colon resection.
  • Intraabdominal drains are sometimes used postoperatively to monitor for leaks or fluid collection.
  • Small bowel obstruction is a potential complication following abdominal surgery.

Observation:

  • An 82-year-old male patient experienced symptoms of small bowel obstruction two days post-laparoscopic anterior resection.
  • Physical examination and diagnostic imaging confirmed mechanical small bowel obstruction.
  • Emergency relaparoscopy was performed to investigate the cause of the obstruction.

Findings:

  • The obstruction was caused by herniation of the small bowel mesentery through the side holes of an intraabdominal drain.
  • This herniation resulted in a 90-degree acute twist of the small bowel, leading to mechanical obstruction.
  • The intraabdominal drain was identified as the direct cause of the mesenteric herniation and subsequent bowel obstruction.

Implications:

  • This case highlights a rare but serious drain-related complication after laparoscopic colectomy.
  • Prompt diagnosis and surgical intervention (relaparoscopy) are crucial for managing this type of obstruction.
  • Reviewing drain placement techniques and considering alternative drainage methods may help prevent similar complications in the future.