S Y Lee1, C H Kim1, Y J Kim1, H R Kim2. 1. Department of Surgery, Chonnam National University Hwasun Hospital and Medical School, 322 Seoyang-ro Hwasun-eup, Hwasun-gun Jeonnam, 58128, Korea. 2. Department of Surgery, Chonnam National University Hwasun Hospital and Medical School, 322 Seoyang-ro Hwasun-eup, Hwasun-gun Jeonnam, 58128, Korea. drkhr@chonnam.ac.kr.
Abstract
PURPOSE: Internal hernia of the small bowel through a mesenteric defect following colorectal cancer surgery is a serious but rarely reported complication. The aim of this study was to evaluate the incidence, clinical features, and management of these hernias. METHODS: We retrospectively reviewed 4589 primary colorectal cancer patients who underwent surgical resection between January 2007 and December 2015. The incidence, clinical presentations, and short-term outcomes of patients with symptomatic internal hernia following colorectal surgery were investigated in detail. RESULTS: We found 9 (0.2 %) patients who presented with symptomatic internal hernia. In all cases, preceding surgical procedures were laparoscopic anterior resection (n = 9), including low anterior resection (n = 3) and intersphincteric resection (n = 3). The median time interval between initial surgery and the occurrence of internal hernia was 4 months (range 5 days-27 months). Main symptoms were abdominal distension and pain; 4 (44.4 %) patients presented with systemic inflammatory response syndrome. Most cases (7/9, 77.8 %) were suspected of internal hernia by preoperative abdominal computed tomography. Six (66.6 %) patients underwent emergency surgery, after which all developed postoperative complications without mortality. The median hospital stay was 27.5 days (range 25-54 days) among patients who underwent surgical intervention. CONCLUSIONS: Internal hernia following colorectal cancer surgery is a rare but potentially fatal complication, and as such, early recognition and management of these cases are important.
PURPOSE: Internal hernia of the small bowel through a mesenteric defect following colorectal cancer surgery is a serious but rarely reported complication. The aim of this study was to evaluate the incidence, clinical features, and management of these hernias. METHODS: We retrospectively reviewed 4589 primary colorectal cancerpatients who underwent surgical resection between January 2007 and December 2015. The incidence, clinical presentations, and short-term outcomes of patients with symptomatic internal hernia following colorectal surgery were investigated in detail. RESULTS: We found 9 (0.2 %) patients who presented with symptomatic internal hernia. In all cases, preceding surgical procedures were laparoscopic anterior resection (n = 9), including low anterior resection (n = 3) and intersphincteric resection (n = 3). The median time interval between initial surgery and the occurrence of internal hernia was 4 months (range 5 days-27 months). Main symptoms were abdominal distension and pain; 4 (44.4 %) patients presented with systemic inflammatory response syndrome. Most cases (7/9, 77.8 %) were suspected of internal hernia by preoperative abdominal computed tomography. Six (66.6 %) patients underwent emergency surgery, after which all developed postoperative complications without mortality. The median hospital stay was 27.5 days (range 25-54 days) among patients who underwent surgical intervention. CONCLUSIONS:Internal hernia following colorectal cancer surgery is a rare but potentially fatal complication, and as such, early recognition and management of these cases are important.
Authors: Adrian A Maung; Dirk C Johnson; Greta L Piper; Ronald R Barbosa; Susan E Rowell; Faran Bokhari; Jay N Collins; Joseph R Gordon; Jin H Ra; Andrew J Kerwin Journal: J Trauma Acute Care Surg Date: 2012-11 Impact factor: 3.313
Authors: Salomone Di Saverio; Fausto Catena; Federico Coccolini; Marica Galati; Nazareno Smerieri; Walter L Biffl; Luca Ansaloni; Gregorio Tugnoli; George C Velmahos; Massimo Sartelli; Cino Bendinelli; Gustavo Pereira Fraga; Michael D Kelly; Frederick A Moore; Vincenzo Mandalà; Stefano Mandalà; Michele Masetti; Elio Jovine; Antonio D Pinna; Andrew B Peitzman; Ari Leppaniemi; Paul H Sugarbaker; Harry Van Goor; Ernest E Moore; Johannes Jeekel Journal: World J Emerg Surg Date: 2013-10-10 Impact factor: 5.469