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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.
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.
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:
- 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.
