Laparoscopic Surgery for Intestinal Obstruction Caused by an Internal Paracecal Hernia.

Paracecal hernia is rarely associated with ischemia and has seldom been reported in the few published studies in the review literature. We present a case of incarcerated paracecal hernia with intestinal obstruction that was effectively treated with laparoscopic intervention. A 64-year-old woman who had not previously undergone any intestinal surgery arrived complaining of abdominal pain and vomiting at our hospital. Abdominal computed tomography suggested intestinal obstruction. A laparoscopic emergency procedure demonstrated an incarcerated small bowel loop in the paracecal region. The confined small bowel was removed from the paracecal area. On the fourth postoperative day, the patient was discharged. This case is unusual because the patient presented with small bowel strangulation, leading to intestinal obstruction. Laparoscopic surgery is beneficial for diagnosing internal hernias and curing small-bowel obstructions caused by paracecal hernias.

A ruptured pancreatic pseudocyst causes acute peritonitis with clinical characteristics of a gastrointestinal tract perforation.

Intraperitoneal air in pancreatic pseudocysts is a rare complication that can jeopardize hemodynamic stability and requires emergency surgery. A 61-year-old man was admitted to our hospital after abdominal pain, vomiting and diarrhea. Computed tomography showed a hollow visceral perforation with intraperitoneal air and two pseudocysts close to the pancreas. The patient was transferred to the emergency operating room with symptoms of septic shock. We histopathologically diagnosed a ruptured pancreatic pseudocyst combined with an intracystic haemorrhage. We resected a portion of the pseudocyst wall using surface electrocautery inside the lumen, cholecystectomy and peritoneal toilet and maintained adequate external drainage. The patient was discharged on postoperative Day 12. The patient achieved relapse-free survival for 12 months postoperatively. Ruptured pancreatic pseudocysts with extraluminal gas are dangerous if effective medical interventions are not performed. Emergency surgery should be completed as soon as possible to drain the pancreatic cyst and cleanse the abdomen.