鼠径ヘルニア嵌頓整復後の小腸狭窄に対し腹腔鏡補助下に手術を行った1例

Abstract

We report a case of a small intestinal obstruction after reduction of an incarcerated inguinal hernia, which was treated by laparoscopy-assisted surgery. A 64-year old man with incarceration of a right inguinal hernia underwent repair by direct Kugel patch method on February 19,2014. From around the 13th day after surgery, he had intermittent abdominal pain and appetite loss. It was thought that the symptoms were caused by an infiammatory change in the small intestine after reduction, but the symptoms were not improved by conservative therapy. On the 28th day after surgery, abdominal CT revealed a narrow segment of small intestine in the right lower abdomen. This segment was resected by laparoscopy-assisted surgery, and pathological examination of the specimen revealed fibrosis of the subserosal layer in the stenosis. We reviewed 7 other cases of small intestinal obstruction after reduction of incarcerated inguinal hernia in Japan. Because bowel obstruction has occurred within one month in such cases, we should follow the patient carefully in this period.