Ileal perforation due to a Richter hernia at the drain insertion site following an operation for idiopathic rectal perforation: report of a case.
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.
Iwase
K
K
Department of Surgery, Rinku General Medical Center, Izumisano Municipal Hospital, Osaka, Japan.
Higaki
J
J
Mikata
S
S
Tanaka
Y
Y
Yoshikawa
M
M
Kishimoto
T
T
Torigai
K
K
Kamiike
W
W
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*