Laparoscopic Management of Small Bowel Obstruction Caused by an Adhesive Internal Hernia Following Open...

Acute intestinal obstruction (AIO) is one of the most common emergency surgical presentations, with small bowel obstruction (SBO) accounting for the majority of cases. Here, we present a case of a 68-year-old female patient who presented to the emergency department with signs and symptoms of SBO. Her medical history was unremarkable except for an open appendectomy performed in her 20s. A computed tomography (CT) scan confirmed the diagnosis of SBO with a transition point in the right iliac fossa with no evidence of ischemia. After the failure of conservative management, diagnostic laparoscopy showed that the SBO was found to be secondary to an internal hernia caused by adhesions. The adhesions were released, and the SBO was resolved; the surgery was completed laparoscopically, enhancing the patient's recovery. This case supports the growing evidence that laparoscopy can be a safe and effective approach for managing SBO, even in cases where conservative management fails. With careful patient selection and surgical expertise, laparoscopy can reduce the need for more invasive procedures and improve patient outcomes.