Laparoscopic management of small bowel obstruction caused by a retrocaecal hernia.

Laparoscopy is not commonly used in the management of small bowel obstruction (SBO). We report the first documented case of laparoscopic diagnosis and treatment of a retrocaecal hernia, a type of internal abdominal hernia. An 86-year-old woman with a chest infection was referred with features of a well-established SBO. At laparoscopy, the hernia was quickly diagnosed and easily reduced, the bowel assessed for viability, and the sac treated by widely laying open its neck, thereby marsupializing the defect. A laparotomy was avoided, and she recovered promptly and without complication. We conclude that laparoscopy can play a useful role in the management of SBO and that its use should be considered in patients with no obvious external hernia and a virgin abdomen in whom an unusual cause is suspected.