A rare case of intestinal obstruction caused by internal hernia through post hysterectomy peritoneal defect

Authors

  • Ravi Kumar Sabu Murugesan Department of General Surgery, Madras Medical College, Chennai, Tamil Nadu, India
  • Kannan Ross Department of General Surgery, Madras Medical College, Chennai, Tamil Nadu, India
  • Joyce Prabakar Department of General Surgery, Madras Medical College, Chennai, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2349-2902.isj20211323

Keywords:

Internal hernia, Intestinal obstruction, Post hysterectomy, Peritoneal defect

Abstract

Internal hernia is a rare cause of intestinal obstruction. Nowadays acquired internal hernias are in increasing trends due to increased surgical procedures thus iatrogenic causes surpassing congenital internal hernias. Internal hernias after hysterectomy due to peritoneal defect is extremely rare. Here we present a case of 67 years old female status post hysterectomy ten years back, also a known type 2 diabetic presented to the emergency department with features suggestive of intestinal obstruction. Patient was taken up for emergency laparotomy and intra operative findings revealed small bowel loops herniating in a cavity that is formed by bladder anteriorly, caecum and sigmoid colon laterally and rectum posteriorly. Bowel loops were released. The bowel was found to be viable and the defect was closed. Bowel movements resumed on the third post-operative day. This case is presented here as it is an extremely rare case of internal hernia causing small bowel obstruction.

References

Internal hernia. Radiology Reference Article, Radiopaedia.org. Available from: https://radiopaedia.org/articles/internal-hernia. Accessed on 10 Jan 2021.

Muthukumar V, Venugopal S, Subramaniam SK. Report of a Case and Review of Literature of Internal Hernia through Peritoneal Defect in Pouch of Douglas: A Rare Occurrence. Int J Appl Basic Med Res. 2017;7(3):196-8.

Inoue Y, Shibata T, Ishida T. CT of internal hernia through a peritoneal defect of the pouch of Douglas. AJR Am J Roentgenol 2002;179:1305-6.

Choi PW. Small Bowel Obstruction Caused by Internal Hernia through a Peritoneal Defect of the Pouch of Douglas: Report of a Case and Review of the Literature. Case Rep Surg. 2017;3.

Ghahremani GG. Internal abdominal hernias. Surg Clin North Am. 1984;64(2):393-406.

Newsom BD, Kukora JS. Congenital and acquired internal hernias: unusual causes of small bowel obstruction. Am J Surg. 1986;152(3):279-85.

Suwa K, Yamagata T, Hanyu K. Internal hernia through a peritoneal defect in the pouch of Douglas: report of a case. Int J Surg Case Rep. 2013;4:115-7.

Hari GS, Sharma D, Srikanth CH. Pouch of Douglas internal hernia successfully treated laparoscopically. J Min Access Surg. 2020;16:271-2.

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Published

2021-03-26

Issue

Section

Case Reports