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[A case of internal hernia through a defect in the falciform ligament treated with laparoscopic surgery]
S Kobayashi1, M Terasaki, T Kuno
1Department of Surgery, Shizuoka Saiseikai General Hospital, Japan.
Insights
Internal hernia through the falciform ligament is a rare condition causing abdominal pain. Early diagnosis via imaging and prompt surgical intervention, potentially laparoscopic, are crucial for successful outcomes.
Area of Science:
- Gastroenterology
- Surgical Innovation
Background:
- Internal hernias are rare causes of bowel obstruction.
- Falciform ligament defects are an exceptionally uncommon site for internal hernias.
Observation:
- A 22-year-old male presented with acute upper abdominal pain.
- Imaging revealed small bowel dilatation between the abdominal wall and liver, suggesting internal hernia.
- Laparoscopic surgery confirmed small bowel incarceration within a falciform ligament defect.
Findings:
- Successful surgical release of incarcerated small intestine.
- Hernia orifice widened to prevent recurrence.
- Patient discharged on postoperative day 4 with no complications.
Implications:
- Characteristic imaging aids in early preoperative diagnosis.
- Prompt surgical management is essential for favorable prognosis.
- Laparoscopic techniques offer a minimally invasive option for eligible patients.
Abstract:
A 22-year-old male was admitted to our hospital with abrupt onset of upper abdominal pain. Abdominal US and CT revealed dilatation of the small intestine between the abdominal wall and a lateral segment of the liver. After a diagnosis of an internal hernia through a defect in the falciform ligament, emergency surgery was performed. Laparoscopic investigation showed incarceration of the small intestine in a defect of the falciform ligament. After releasing an incarceration, the hernia orifice was opened to prevent relapse. He was discharged on the 4th postoperative day. Internal hernia through a defect in the falciform ligament is extremely rare, with six reported cases including our own in Japan. Characteristic images of abdominal US and CT enable preoperative diagnosis of this condition. Surgery should be performed at an early stage after onset. In patients with no prior history of surgery, laparoscopic techniques may be useful.