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Case report: Complex retroperitoneal herniation after abdominoperineal resection.

Fuad Alkhoury¹, Jeremiah Martin

¹Department of Pediatric Surgery, Miami Children's Hospital, 3200 S.W. 60th Court, Suite 201, Miami, FL 33155, USA.

International Journal of Surgery Case Reports

|September 15, 2012

Summary

A rare retroperitoneal hernia into the colonic mesentery occurred after rectal cancer surgery (abdominiperineal resection). This case highlights the importance of vigilance and imaging for timely management of such unusual hernias.

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Area of Science:

Gastroenterology
Surgical Oncology
Abdominal Surgery

Background:

A rare complication following abdominiperineal resection (APR) for rectal cancer is retroperitoneal hernia into the colonic mesentery.
This case report details a 70-year-old male presenting with complete small bowel obstruction due to this specific type of hernia.

Purpose of the Study:

To report the first known case of small bowel obstruction caused by a retroperitoneal hernia into the colonic mesentery post-APR.
To discuss the management of the pelvic space after APR and preventative strategies.
To review the literature on retroperitoneal hernias in adults.

Main Methods:

Case presentation of a 70-year-old male with symptoms of bowel obstruction.
Surgical intervention for hernia reduction.

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Literature review on retroperitoneal hernias and post-APR pelvic space management.

Main Results:

Successful operative repair and reduction of the complex retroperitoneal hernia.
Identification of this as a rare cause of small bowel obstruction post-APR.

Conclusions:

Retroperitoneal hernias are rare in adults, but can cause significant complications like small bowel obstruction.
Closure of the pelvic peritoneum after APR may help prevent such complications.
Vigilance and thorough imaging are crucial for effective diagnosis and management.