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Internal hernia and small bowel obstruction caused by a linear cutter staple at appendiceal stump following

Lindsay F Petersen1, Mary C Nally1, Andrew Agos2

  • 1Department of General Surgery, Rush University Medical Center, Chicago, IL, USA.

Journal of Surgical Case Reports
|May 31, 2014
PubMed

Insights

A rare complication of laparoscopic appendectomy occurred when a staple on the appendiceal stump caused a small bowel obstruction via internal hernia. Surgeons should consider removing any free staples during surgery to prevent potential obstructions.

Area of Science:

  • Gastroenterology
  • Surgical Innovation
  • Abdominal Surgery

Background:

  • Laparoscopic appendectomy is a standard procedure for appendicitis.
  • Linear staplers are commonly used to transect the appendix and secure the appendiceal stump.

Observation:

  • A patient developed a small bowel obstruction with internal hernia less than one week after a laparoscopic appendectomy.
  • The obstruction was caused by a surgical staple located on the appendiceal stump.

Findings:

  • This case highlights a rare complication of staple use in laparoscopic appendectomy.
  • Literature review indicates that free staples in the abdomen, often remote from the staple line, are more commonly associated with complications.

Implications:

  • The findings suggest that even staples on the stump, not just free staples, can cause serious complications like internal hernias.
  • Recommendations include careful inspection and potential removal of all noted staples, even those on the stump, during laparoscopic appendectomy to mitigate risks of bowel obstruction.

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