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Transmesenteric internal hernia: an unexpected adverse event induced by colonoscopy
Ikue Sekai1, Kosuke Minaga2, Akane Hara1
1Department of Gastroenterology and Hepatology, Faculty of Medicine, Kindai University, Ohno-Higashi 377-2, Osaka-Sayama, Osaka, 589-8511, Japan.
Clinical Journal of Gastroenterology
|July 3, 2024
Summary
Colonoscopy can rarely cause transmesenteric internal hernia in patients with prior laparoscopic surgery. This rare complication involves small bowel obstruction due to mesenteric defects, requiring prompt surgical intervention.
Area of Science:
- Gastroenterology
- Surgical Innovation
- Abdominal Surgery
Background:
- Transmesenteric internal hernia is a rare cause of small bowel obstruction.
- Patients undergoing laparoscopic surgery are at risk for iatrogenic mesenteric defects.
Observation:
- An 81-year-old male developed severe abdominal pain post-colonoscopy.
- Imaging revealed strangulated small bowel obstruction with a closed-loop formation.
- Laparotomy identified small bowel herniating through a mesenteric defect into the left retroperitoneal space.
Findings:
- The mesenteric defect was inadvertently created during a prior laparoscopic left nephrectomy.
- Small bowel loops prolapsed through the defect, causing incarceration and obstruction.
- Successful surgical repair involved detaching the bowel and closing the mesenteric defect.
Implications:
- Colonoscopy may precipitate transmesenteric internal hernia in patients with prior laparoscopic surgery.
- Awareness of this risk is crucial for preventing delayed diagnosis and treatment.
- Careful surgical technique and patient selection are important in laparoscopic procedures.
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