Small Bowel Obstruction Caused by a Paracecal Hernia Repaired by Laparoscopic Surgery

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  • Gunjigake Katsuya
    Department of Surgery, Japan Community Health Care Organization Kanazawa Hospital
  • Yasui Toshiaki
    Department of Surgery, Japan Community Health Care Organization Kanazawa Hospital

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Other Title
  • 腹腔鏡下に腸閉塞解除術を施行した盲腸周囲ヘルニアの1例
  • フククウキョウ カ ニ チョウ ヘイソク カイジョジュツ オ シコウ シタ モウチョウ シュウイ ヘルニア ノ 1レイ

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Abstract

<p>A 63-year-old man who had undergone gastrectomy presented with a history of abdominal pain, nausea and vomiting. Examination revealed tenderness in the right lower quadrant. Abdominal computed tomography showed evidence of obstruction of the small intestine in the lower right abdomen. We diagnosed small bowel obstruction caused by adhesions. After introduction of a transnasal ileus tube, contrast radiography of the intestines showed interruption of the contrast medium where the tip of the tube reached the site of obstruction in the right lower abdomen. On the 7th hospital day, laparoscopic surgery was performed to treat the small bowel obstruction, as the conservative treatment appeared to be inadequate to resolve the ileus. Intraoperative findings revealed a lateral type of paracecal hernia with small bowel obstruction. A review of the preoperative CT images revealed a small intestinal loops on the dorsolateral aspect of the cecum, which is considered as a characteristic finding of paracecal hernia.</p>

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