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Retroperitoneal hernia following radical cystectomy: case report.

A Kamyab1, P Hurley, M J Jacobs

  • 1Department of Surgery, Providence Hospital and Medical Centers, Southfield, MI 48075, USA.

Hernia : the Journal of Hernias and Abdominal Wall Surgery
|June 14, 2011
PubMed
Summary

Retroperitoneal hernias are rare but can occur in patients with prior urological surgery. A case highlights how ureteral dissection can create defects leading to small bowel strangulation, emphasizing vigilance in post-operative patients.

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Area of Science:

  • Urology
  • Gastroenterology
  • Surgical Anatomy

Background:

  • Retroperitoneal hernias are uncommon, often arising in congenital fossae.
  • Prior urological surgery may increase the risk of retroperitoneal hernia formation due to anatomical alterations.

Observation:

  • A 76-year-old male with a history of radical cystectomy and ileal loop conduit presented with recurrent nausea and vomiting.
  • Exploratory laparotomy revealed a retroperitoneal hernia with a strangulated loop of small bowel.

Findings:

  • The patient's prior ureteral dissection created a peritoneal defect, allowing small bowel herniation.
  • Resection of the strangulated small bowel was performed successfully, with the patient recovering without complications.

Implications:

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  • Retroperitoneal hernias may be an under-diagnosed cause of intestinal obstruction in post-operative urological patients.
  • Thorough review of surgical history, including non-general surgical procedures, and anatomical knowledge are crucial for diagnosis.
  • Delayed intervention for small bowel obstruction in these patients can lead to significant bowel compromise.