title: Ileal perforation due to a Richter hernia at the drain insertion site following an operation for idiopathic rectal perforation: report of a case.
abstract: A case of a Richter hernia at the insertion site of the drainage tube following open abdominal surgery is reported. A 54-year-old man underwent an emergency operation for an idiopathic rectal perforation. A partial resection of the rectum and drainage using four 10-mm (outer diameter) drainage tubes with round cross sections was performed. Despite an uneventful early postoperative course, an emergency reoperation was required for peritonitis due to a bowel perforation 14 days after removing the drain inserted into the rectosacral space. A laparotomy revealed an incarcerated Richter hernia with ileal perforation through the 10-mm drainage site. The postoperative course after a partial resection of the ileum and drainage with Penrose drains was uneventful. This is the first report of a Richter hernia through the insertion site of a drainage tube in abdominal surgery. The possible occurrence of a Richter hernia in cases with postoperative drainage using large-size round drainage tubes should thus be considered in such patients.
authors.affiliation: Department of Surgery, Rinku General Medical Center, Izumisano Municipal Hospital, Osaka, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Iwase
authors.forename: J
authors.initials: J
authors.lastname: Higaki
authors.forename: S
authors.initials: S
authors.lastname: Mikata
authors.forename: Y
authors.initials: Y
authors.lastname: Tanaka
authors.forename: M
authors.initials: M
authors.lastname: Yoshikawa
authors.forename: T
authors.initials: T
authors.lastname: Kishimoto
authors.forename: K
authors.initials: K
authors.lastname: Torigai
authors.forename: W
authors.initials: W
authors.lastname: Kamiike
mesh_terms: D004322:Drainage; D006555:Hernia, Ventral / Q000150:complications* / Q000209:etiology; D006801:Humans; D007077:Ileal Diseases / Q000209:etiology*; D007416:Intestinal Perforation / Q000209:etiology* / Q000601:surgery; D007440:Intubation / Q000009:adverse effects* / Q000295:instrumentation; D008297:Male; D008875:Middle Aged; D012002:Rectal Diseases / Q000601:surgery*