title: Intestinal blood flow assessment by indocyanine green fluorescence imaging in a patient with the incarcerated umbilical hernia: Report of a case.
abstract: After reduction of the incarceration during surgery for incarcerated hernia, intestinal blood flow (IBF) and the need for bowel resection must be evaluated. We report the case of a patient with incarcerated umbilical hernia in whom the bowel was preserved after evaluating IBF using indocyanine green (ICG) fluorescence. A woman in her 40s with a chief complaint of abdominal pain visited our hospital, was diagnosed with incarcerated umbilical hernia and underwent surgery. Laparotomy was performed to reduce bowel incarceration. After reducing the incarceration, IBF was observed using ICG fluorescence detected using a brightfield full-color fluorescence camera. The small bowel that had been incarcerated showed deep-red discoloration on gross evaluation, but intravenous injection of ICG revealed uniform fluorescence of the mesentery and bowel wall. This indicated an absence of irreversible ischemic changes of the bowel, so no resection was performed. The patient showed a good postoperative course, including resumption of eating on day 4 and discharge on day 11. In surgery for incarcerated hernia, ICG fluorescence may offer a useful method to evaluate IBF after reducing the incarceration. This case implied that PINPOINT could be used in open conventional surgery.
authors.affiliation: Department of Surgery, International University of Health and Welfare Hospital, 537-3, Iguchi, Nasushiobara City, Tochisgi, 329-2763, Japan.
authors.forename: Shunjin
authors.initials: S
authors.lastname: Ryu
authors.affiliation: Department of Surgery, International University of Health and Welfare Hospital, 537-3, Iguchi, Nasushiobara City, Tochisgi, 329-2763, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Yoshida
authors.affiliation: Department of Surgery, International University of Health and Welfare Hospital, 537-3, Iguchi, Nasushiobara City, Tochisgi, 329-2763, Japan.
authors.forename: Hironori
authors.initials: H
authors.lastname: Ohdaira
authors.affiliation: Department of Surgery, International University of Health and Welfare Hospital, 537-3, Iguchi, Nasushiobara City, Tochisgi, 329-2763, Japan.
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Tsutsui
authors.affiliation: Department of Surgery, International University of Health and Welfare Hospital, 537-3, Iguchi, Nasushiobara City, Tochisgi, 329-2763, Japan.
authors.forename: Norihiko
authors.initials: N
authors.lastname: Suzuki
authors.affiliation: Department of Surgery, International University of Health and Welfare Hospital, 537-3, Iguchi, Nasushiobara City, Tochisgi, 329-2763, Japan.
authors.forename: Eisaku
authors.initials: E
authors.lastname: Ito
authors.affiliation: Department of Surgery, International University of Health and Welfare Hospital, 537-3, Iguchi, Nasushiobara City, Tochisgi, 329-2763, Japan.
authors.forename: Keigo
authors.initials: K
authors.lastname: Nakajima
authors.affiliation: Department of Surgery, International University of Health and Welfare Hospital, 537-3, Iguchi, Nasushiobara City, Tochisgi, 329-2763, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Yanagisawa
authors.affiliation: Department of Surgery, International University of Health and Welfare Hospital, 537-3, Iguchi, Nasushiobara City, Tochisgi, 329-2763, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Kitajima
authors.affiliation: Department of Surgery, International University of Health and Welfare Hospital, 537-3, Iguchi, Nasushiobara City, Tochisgi, 329-2763, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Suzuki
keywords: CT, computed tomography; Case report; IBF, intestinal blood flow; ICG fluorescence; ICG, indocyanine green; Intestinal blood flow; NOMI, non-occlusive mesenteric ischemia; Umbilical hernia