Laparoscopic Reduction and Repair of a Mesocolic Hernia Causing Small Bowel Obstruction: A Case Report and Review of Literature.

Mesocolic hernias are a rare cause of small bowel obstruction that occurs when a loop of small bowel herniates through a defect in the mesocolon. We present a case of a 35-year-old male with a mesocolic hernia causing small bowel obstruction, who was successfully treated with laparoscopic reduction and repair. The patient had an uneventful recovery and was discharged on postoperative day 3. Mesocolic hernias should be considered in the differential diagnosis of small bowel obstruction, and prompt diagnosis and surgical intervention are essential to prevent complications such as bowel ischemia and perforation. Laparoscopic treatment can be a safe and effective option for the management of mesocolic hernias. This case report highlights the clinical presentation, radiological features, and surgical management of mesocolic hernias, with a focus on the role of laparoscopy in the treatment of this rare condition.

Examination of anastomotic leak with aqueous contrast swallow after total gastrectomy: Should it be carried out routinely?

AIM OF THE STUDY: Examination of esophagojejunal (EJ) anastomosis with aqueous contrast swallow after total gastrectomy is still routinely conducted by many centres. The present study aimed to answer the question: Is it necessary to evaluate EJ anastomosis in terms of leakage by having every patient drink oral contrast agent before initiation of oral food intake after total gastrectomy (TG) performed due to gastric cancer? MATERIAL AND METHODS: Clinical and radiological results of patients on whom total gastrectomy was performed due to gastric cancer between January 2013 and December 2016 were retrospectively reviewed. Diagnostic method used for patients in whom leak developed and therapeutic interventions were assessed. Evaluation results from aqueous contrast agent and clinical, laboratory, and tomographic findings were studied. RESULTS: Sixty of the 69 patients who underwent total gastrectomy with a diagnosis of gastric adenocarcinoma swallowed aqueous contrast agent on postoperative day 7 ±2 days and were evaluated in terms of anastomotic leak. Leak developed in 14 patients (20.2 %), 10 of whom ingested contrast agent. Leak was identified in 6 of those patients; however, diagnosis was made with multislice computed tomography (CT) in four patients (40%). The sensitivity of the examination with aqueous contrast agent was 60%. CONCLUSIONS: Evaluating anastomotic leak with aqueous contrast agent after TG has low sensitivity, and it would be wise to resort to this procedure in cases with clinical suspicion, rather than routinely performing it in every patient.