Strangulated internal hernia through the lesser omentum with intestinal necrosis: a case report
São Paulo med. j
;
120(3): 84-86, May 2002. ilus
Article
in English
| LILACS
| ID: lil-312171
RESUMO
CONTEXT Internal hernias account for only 0.2 to 0.9 percent of the cases of intestinal obstruction. They do not have specific clinical manifestations, and are usually diagnosed during laparotomy for acute intestinal obstruction. Internal hernias through the lesser omentum are extremely rare. CASE REPORT We report here the case of a 36-year-old patient who underwent exploratory laparotomy for acute intestinal obstruction. An internal hernia through the lesser omentum was found, with a strangulated ileal segment passing through the perforation into an abscess within the lesser sac. The surgical procedures included ileal resection, primary anastomosis, abscess removal, and placement of a drain in the lesser sac. The patient was reoperated 6 days later for abdominal sepsis; a lesser sac abscess was removed and the abdominal incision was left open. The patient stayed in the Intensive Care Unit for 15 days, and eventually left the hospital on the 28th post-admission day, with complete recovery thereafter. CONCLUSION:
The early diagnosis of acute intestinal obstruction and immediate indication for laparotomy is the main task of the surgeon when faced with a case of acute abdomen with a hypothesis of internal hernia, so as to minimize severe postoperative complications, as illustrated by the present case
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Omentum
/
Abdomen, Acute
/
Hernia, Ventral
/
Ileal Diseases
/
Intestinal Obstruction
Type of study:
Screening study
Limits:
Adult
/
Humans
/
Male
Language:
English
Journal:
São Paulo med. j
Journal subject:
Cirurgia Geral
/
Cincia
/
Ginecologia
/
Medicine
/
Medicina Interna
/
Obstetr¡cia
/
Pediatria
/
Sa£de Mental
/
Sa£de P£blica
Year:
2002
Type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
Universidade de Säo Paulo/BR
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