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Mesocolic hernia after laparoscopic transverse colectomy: A case report.
Ken-Ichi Oshiro1, Koji Koinuma2, Misaki Matsumiya1
1Department of Surgery, Shin-Oyama City Hospital, 2251-1, Oyama, Tochigi 323-0827, Japan.
International Journal of Surgery Case Reports
|December 16, 2019
Summary
Internal hernias are rare complications after laparoscopic colorectal surgery. This case highlights a left transverse mesocolon defect causing internal hernia, suggesting closure may be warranted for this specific anatomical location.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Abdominal Surgery
Background:
- Internal hernias are infrequent but serious complications following laparoscopic colorectal resections.
- Mesenteric defects created during surgery can lead to internal herniation of the bowel.
Observation:
- A 52-year-old male developed sudden abdominal pain and vomiting 30 days post-laparoscopic colectomy for transverse colon cancer.
- Computed tomography revealed strangulated small intestine within a mesenteric defect in the left upper abdomen.
- Emergency laparotomy identified 130 cm of herniated small intestine through a 5 cm defect in the transverse mesocolon.
Findings:
- The mesenteric defect, created during the laparoscopic procedure, was not closed.
- No bowel resection was required; the defect was repaired with non-absorbable sutures.
- The patient experienced paralytic ileus post-operatively, which resolved without intervention.
Implications:
- While rare, internal hernias through mesenteric defects can occur after laparoscopic colorectal surgery.
- Routine closure of all mesenteric defects may not be necessary.
- Left-sided transverse mesocolon defects pose a higher anatomical risk for internal hernia formation and may warrant closure.
