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Emergency laparoscopic surgery on a patient who visited the emergency room with lower abdominal pain

  • Hyo Jeong Choi1,†
  • Seung Yeun Jang2,†
  • Ho Jung Kim3,*,

1Department of Paramedicine, Sun Moon University, 31460 Asan-si, Republic of Korea

2Department of Emergency Medicine, Boramae Medical Center, 07061 Seoul, Republic of Korea

3Department of Emergency Medicine, Soonchunhyang University Bucheon Hospital, 14584 Bucheon-si, Republic of Korea

DOI: 10.22514/sv.2023.092 Vol.19,Issue 5,September 2023 pp.250-253

Submitted: 03 June 2022 Accepted: 18 October 2022

Published: 08 September 2023

*Corresponding Author(s): Ho Jung Kim E-mail: lovelydr@schmc.ac.kr

† These authors contributed equally.

Abstract

Internal hernias account for fewer than 6% of all small intestinal obstructions; of these, hernias caused by defects in the sigmoid colon are particularly challenging to detect. Misdiagnosis may occur if non-surgical symptoms (such as rebound tenderness) are not observed in the emergency room. We report the case of a consent who visited the emergency room with recurrent non-specific lower abdominal pain. She exhibited an internal hernia that had triggered small intestinal ischemia between the mesosigmoid (mesentery) and ovary. A 36-year-old female patient visited the emergency room of our hospital with acute left-lower abdominal pain, nausea, and vomiting that occurred 1 h after meals. We found no palpable mass or enlarged organ. Abdominal computed tomography (CT) revealed segmental small bowel wall thickening with mesenteric congestion in the left-lower quadrant, and small bowel ischemia attributable to internal herniation or adhesion. In addition, a small amount of pelvic ascites and multiple liver cysts were observed. A surgeon was immediately consulted and emergency laparoscopic surgery was performed.


Keywords

Abdominal pain; Internal hernia; Small bowel ischemia; Adhesion band; Emergency center


Cite and Share

Hyo Jeong Choi,Seung Yeun Jang,Ho Jung Kim. Emergency laparoscopic surgery on a patient who visited the emergency room with lower abdominal pain. Signa Vitae. 2023. 19(5);250-253.

References

[1] Newsom B.D, Kukora J.S. Congenital and acquired internal hernias: unusual causes of small bowel obstruction. The American Journal of Surgery. 1986; 152: 279–285.

[2] Clemenz FW, Kemmerer WT. Intersigmoid hernia: review of the literature and report of an additional case. Archives of Surgery. 1967; 94: 22–24.

[3] Salar O, Sharkawy A.M.El, Singh R, Speake W. Internal hernias: a brief review. Hernia. 2013; 17: 373–377.

[4] Doishita S, Takeshita T, Uchima Y, Kawasaki M, Shimono T, Yamashita A, et al. Internal hernias in the era of multidetector CT: correlation of imaging and surgical findings. Radiographics. 2016; 36: 88–106.

[5] Miller G, Boman J, Shrier I, Gordon PH. Etiology of small bowel obstruction. The American Journal of Surgery. 2000; 180: 33–36.

[6] Macaluso, Christopher R, and Robert M McNamara. Evaluation and management of acute abdominal pain in the emergency department. International Journal of General Medicine. 2012; 5: 789–797.

[7] Garza E Jr, Kuhn J, Arnold D, Nicholson W, Reddy S, McCarty T. Internal hernias after laparoscopic Roux-en-Y gastric bypass. The American Journal of Surgery. 2004; 188: 796–800.

[8] Lee HW, Jo GS, Kim HC, Rim CW, Sin EJ, Ju JU, et al. Internal hernia through long-term loss with intestinal obstruction: a case. 2006. Available at: https://www.dbpia.co.kr/pdf/pdfView. do?nodeId=NODE01912210&googleIPSandBox=false&mark=0&useDate=&ipRange=false&accessgl=Y&language=ko_KR& hasTopBanner=true (Accessed: May 2022).

[9] Chung IY, Moon SH, Park HC, Park KJ. Small bowel obstruction in patients without a previous history of abdominal operation. Journal of the Korean Society of Coloproctology. 2007; 23: 16–21.

[10] Weibel MA, Majno G. Peritoneal adhesions and their relation to abdominal surgery: a postmortem study. The American Journal of Surgery.1973; 126: 345–353.

[11] Liakakos T, Theodoros N, Fine PM, Dervenis C, Young RL. Peritoneal adhesions: etiology, pathophysiology, and clinical significance. Digestive Surgery. 2001; 18: 260–273.

[12] Takeyama N, Gokan T, Ohgiya Y, Satoh S, Hashizume T, Hataya K, et al. CT of internal hernias. RadioGraphics. 2005; 25: 997–1015.

[13] Megibow AJ, Balthazar EJ, Cho KC, Medwid SW, Birnbaum BA, Noz ME. Bowel obstruction: evaluation with CT. Radiology. 1991; 180: 313–318.

[14] Ishihara H, Terahara M, Kigawa J, Terakawa N. Strangulated herniation through a defect of the Broad ligament of the uterus. Gynecologic and Obstetric Investigation.1993; 35: 187–189.


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