Erschienen in:
13.01.2021 | Surgical Techniques and Innovations
Laparoscopic Repair of Internal Hernias: a Case Series with Review of Literature
verfasst von:
Rafique Umer Harvitkar, Abhijit Joshi
Erschienen in:
Indian Journal of Surgery
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Ausgabe 6/2021
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Abstract
Internal hernias are rare clinical entities. They are potentially life-threatening, yet often neglected and sometimes misdiagnosed surgical conditions. Herein, we report five different cases of internal hernia in adults aged 29–42 years. These include one case each of right and left paraduodenal hernia, two cases of broad ligament hernia and one case of post lower segment caesarean section adhesions related internal hernia. The patients had varied clinical features, presenting with abdominal pain with or without nausea or vomiting and signs of intestinal obstruction. Contrast-enhanced computed tomography of the abdomen accurately diagnosed the two paraduodenal herniae and one of the two broad ligament hernia cases, pre-operatively. It revealed dilated contrast filled small bowel loops with an abrupt transition zone in the left lower abdomen (second broad ligament hernia case) and in the right lower abdomen (adhesion-related internal hernia case). Laparoscopic repair was performed in all five cases, and they were discharged 3–4 days later without any further complication. Clinicians should have a high index of suspicion for internal hernias, especially in those patients who present with chronic, vague, non-specific symptoms, after having ruled out the commoner differential diagnoses. We hope to highlight that even in patients who present with intestinal obstruction, laparoscopy is a viable therapeutic option.