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Two cases of an internal hernia after laparoscopic sigmoid resection

Two patients with a laparoscopic resection of the sigmoid colon in their surgical history were diagnosed with an internal hernia because of a mesenteric gap underneath the descending neocolon. While the first case demonstrated a strongly symptomatic patient with a closed-loop obstruction of the smal...

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Autores principales: Plath, Liane, Burger, Reint, Bueter, Marco, Thalheimer, Andreas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8990697/
https://www.ncbi.nlm.nih.gov/pubmed/35393282
http://dx.doi.org/10.1136/bcr-2022-249468
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author Plath, Liane
Burger, Reint
Bueter, Marco
Thalheimer, Andreas
author_facet Plath, Liane
Burger, Reint
Bueter, Marco
Thalheimer, Andreas
author_sort Plath, Liane
collection PubMed
description Two patients with a laparoscopic resection of the sigmoid colon in their surgical history were diagnosed with an internal hernia because of a mesenteric gap underneath the descending neocolon. While the first case demonstrated a strongly symptomatic patient with a closed-loop obstruction of the small bowel, the second case was less obvious and correct diagnosis was achieved after a few weeks by finally performing a diagnostic laparoscopy. Since internal hernias after laparoscopic sigmoid resection are a rare complication and as presented in the second case can display very unspecific symptoms, the surgeon’s awareness is not immediately raised towards it. Therefore, an asymptomatic internal hernia bears a constant risk of a life-threatening outcome allowing to recommend an initial closure of the mesenteric gap. In both cases, successful treatment was achieved by surgery and intraoperatively closing the remaining mesenteric gap. Subsequently recovery and follow-up were uneventful.
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spelling pubmed-89906972022-05-12 Two cases of an internal hernia after laparoscopic sigmoid resection Plath, Liane Burger, Reint Bueter, Marco Thalheimer, Andreas BMJ Case Rep Case Reports: Reminder of important clinical lesson Two patients with a laparoscopic resection of the sigmoid colon in their surgical history were diagnosed with an internal hernia because of a mesenteric gap underneath the descending neocolon. While the first case demonstrated a strongly symptomatic patient with a closed-loop obstruction of the small bowel, the second case was less obvious and correct diagnosis was achieved after a few weeks by finally performing a diagnostic laparoscopy. Since internal hernias after laparoscopic sigmoid resection are a rare complication and as presented in the second case can display very unspecific symptoms, the surgeon’s awareness is not immediately raised towards it. Therefore, an asymptomatic internal hernia bears a constant risk of a life-threatening outcome allowing to recommend an initial closure of the mesenteric gap. In both cases, successful treatment was achieved by surgery and intraoperatively closing the remaining mesenteric gap. Subsequently recovery and follow-up were uneventful. BMJ Publishing Group 2022-04-07 /pmc/articles/PMC8990697/ /pubmed/35393282 http://dx.doi.org/10.1136/bcr-2022-249468 Text en © BMJ Publishing Group Limited 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Case Reports: Reminder of important clinical lesson
Plath, Liane
Burger, Reint
Bueter, Marco
Thalheimer, Andreas
Two cases of an internal hernia after laparoscopic sigmoid resection
title Two cases of an internal hernia after laparoscopic sigmoid resection
title_full Two cases of an internal hernia after laparoscopic sigmoid resection
title_fullStr Two cases of an internal hernia after laparoscopic sigmoid resection
title_full_unstemmed Two cases of an internal hernia after laparoscopic sigmoid resection
title_short Two cases of an internal hernia after laparoscopic sigmoid resection
title_sort two cases of an internal hernia after laparoscopic sigmoid resection
topic Case Reports: Reminder of important clinical lesson
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8990697/
https://www.ncbi.nlm.nih.gov/pubmed/35393282
http://dx.doi.org/10.1136/bcr-2022-249468
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