Small bowel obstruction secondary to herniation through a 5-mm laparoscopic trocar site following laparoscopic lymphadenectomy.
Incisional hernias occur in <1% of women undergoing operative laparoscopy and are mostly limited to trocar sites > or =10 mm. This is a report of a 54-year-old woman with endometrial cancer who presented with nausea, vomiting and abdominal pain 1 week following laparoscopically-assisted vaginal hysterectomy, bilateral salpingo-oophorectomy, and lymphadenectomy. Abdominal radiographs and computed tomography demonstrated small bowel obstruction and herniation through a 5-mm trocar site. Reduction of the hernia and closure of the fascial incision were performed at exploratory laparotomy with normal recovery. Bowel herniation can occur through 5-mm trocar sites following prolonged operative laparoscopy. The peritoneum and fascia of these incisions should be closed.
Eltabbakh
G H
GH
Division of Gynecologic Oncology, University of Vermont, Burlington 05401, USA.
D005260:Female; D006547:Hernia / Q000150:complications* / Q000000981:diagnostic imaging / Q000209:etiology*; D006801:Humans; D007045:Hysterectomy, Vaginal / Q000009:adverse effects; D007415:Intestinal Obstruction / Q000000981:diagnostic imaging / Q000209:etiology*; D007579:Jejunal Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D010535:Laparoscopy / Q000009:adverse effects*; D008197:Lymph Node Excision / Q000009:adverse effects*; D008875:Middle Aged; D011183:Postoperative Complications; D014057:Tomography, X-Ray Computed