Small bowel obstruction from internal hernia as a complication of colonoscopy

Successful Retrocecal Hernia Diagnosis and Treatment: A Case Report

Introduction

A retrocecal hernia is a rare type of internal hernia that occasionally causes small bowel obstruction and strangulation ileus. We report a case of retrocecal hernia that was preoperatively diagnosed using multidetector raw computed tomography and successfully treated by emergency surgery.

Case Presentation

A 97-year-old woman presented at another hospital with abdominal distension and nausea. She was diagnosed with ileus and was conservatively treated with long intestinal tube placement. However, the symptoms had not improved after 7 days in the hospital. The patient was then referred to our hospital, where a pericecal hernia was diagnosed using multidetector raw computed tomography. We performed emergency surgery and intraoperatively confirmed the presence of a retrocecal hernia. A 30-cm nonviable section of small intestine was resected, and the hernia orifice was closed routinely. Postoperative recovery was uneventful.

Conclusions

Patients with pericecal hernia usually require surgical treatment. Multidetector raw computed tomography is useful for precise diagnosis of this type of hernia. Precise diagnosis is necessary to select prompt operative intervention for internal hernia.

Paracecal hernia due to membranous adhesion of the omentum to the right paracolic gutter

BACKGROUND

Paracecal hernias, also known as pericecal hernias, are an exceptionally rare type of internal hernia. We report a unique case of paracecal hernia due to membranous adhesion of the omentum to the right paracolic gutter.

CASE PRESENTATION

An 86-year-old female was admitted to our hospital with vomiting and abdominal pain. Laboratory findings showed a slightly elevated C-reactive protein level. Computed tomography scan showed dilated loops of the small intestine in the right paracolic gutter with medial displacement of the cecum and ascending colon. Internal hernia around the cecum due to postoperative adhesion after appendectomy was suspected, and she underwent emergency laparotomy. Intraoperative findings revealed the adhesion between the omentum and right paracolic gutter forming a cavity with the small intestine incarcerated. No abnormal adhesion in the ileocecal region was seen. We transected the omental adhesion from the orifice to the far end of the cavity near the hepatic flexure of the colon to release strangulation and to prevent recurrence. The patient was discharged on postoperative day 14 without complications.

CONCLUSIONS

Paracecal hernias have a type of membranous adhesion of the omentum to the right paracolic gutter. Surgeons should be aware of this paracecal hernia type, when they encounter the internal hernia.

Laparoscopic surgery for the diagnosis and treatment of a paracecal hernia repair: Report of a case

Internal hernias are relatively rare viscous protrusions through a defect in the peritoneal cavity. Paracecal hernia is one of the least common types, and only a few cases have been reported to date. We herein present the case of a 43-year-old woman, who was preoperatively diagnosed to have a small bowel obstruction caused by a paracecal hernia resulting from intestinal protrusion and invagination into a paracecal pouch. Laparoscopic surgery was performed for definitive diagnosis and treatment. The surgery achieved a good outcome and the patient experienced an uneventful perioperative course.

Ileal entrapment within a paracaecal hernia mimicking acute appendicitis

Presented is a case of incarcerated paracaecal hernia mimicking acute appendicitis. The clinical scenario highlights the need for a high index of suspicion in the management of patients with localised peritonism even in the absence of obstructive symptoms and the presence of normal laboratory markers of inflammation. Whilst computed tomography might offer a pre-operative diagnosis, in such a low-risk patient laparoscopy offers the combined advantages of immediate diagnosis and definitive treatment of acute pathology.

Small bowel obstruction complicating colonoscopy: a case report

Introduction

This report describes a rare complication of colonoscopy and reviews the literature with regard to other rare causes of acute abdominal presentations following colonoscopy.

Case presentation

After a therapeutic colonoscopy a 60-year-old woman developed an acute abdomen. At laparotomy she was discovered to have small bowel obstruction secondary to incarceration through a congenital band adhesion.

Conclusion

Although there is no practical way in which such rare complications can be predicted, this case report emphasises the wide array of pathologies that can result in acute abdominal symptoms following colonoscopy.

Red herring: a rare cause of small bowel obstruction

This is a case report of a 73-year-old man with a small bowel obstruction secondary to an incarcerated paracaecal hernia. His large right inguinal hernia, initially suspected as a potential source of obstruction, turned out to be a red herring. Congenital internal hernias are a very rare cause of bowel obstruction. In this report we review the literature and embryology behind these uncommon occurrences.

Mechanical small bowel obstruction precipitated by colonoscopy

Mechanical small bowel obstruction (SBO) is rare complication of colonoscopy. We present a patient who developed SBO 24 h after surveillance colonoscopy. Four years prior to this procedure, he had undergone augmentation cecocystoplasty with continent ileal conduit. He subsequently underwent laparotomy and lysis of a band adhesion that caused extrinsic compression of the ileum proximal to ileotransverse colostomy. We further review the literature, describe the salient features of colononoscopy-induced bowel obstruction, and identify the risk factors for this unusual complication.