Small bowel perforation due to an adhesion ruptured by peritoneal insufflation

Background:Despite the widespread use of laparoscopic cholecystectomy, technical complications unique to the laparoscopic approach may lead to significant postoperative morbidity and mortality. Case report: We report the first published case of small bowel fistula due to peritoneal insufflation that broke a thin string adhesion between the peritoneal wall and a jejunal segment, which lead to a focal perforation in a 75-year-old woman. Leakage of enteric fluid through the umbilical scar indicated this adverse event during the early postoperative period. The patient was immediately and successfully treated with a suture of the intestinal lesion. Conclusion: Peritoneal insufflation induced for laparoscopic procedures may break abdominal adhesions and lead to organs and vascular injuries, including small bowel perforation.