Arellano-Borja A, Mojarra-Estrada JM, Ungson-Beltrán G

Language: Spanish
References: 15
Page: 117-121
PDF size: 286.82 Kb.

ABSTRACT

Richter’s hernia is a type of hernia that involves the antimesenteric border of small intestine and causes strangulation of only that part of the circumference of the bowel wall. The incidence of site trocar hernia is in 21 of 100,000 cases in gynecological laparoscopies surgery, most commonly in extraumbilicals sites and trocars of 10 mm or larger, rarely occurs in 5 mm incisions. Its contents involved small intestine (84.2%) and less frequently colon and omentum. It is associated with perforation of incarcerated small bowel loop. We present a patient who underwent a laparoscopic myomectomy, 48 hours after the procedure presents data from acute abdomen, undergoing to exploratory laparoscopy, found in site 5 mm lateral port a Richter's hernia, which is treated with primary closure with laparoscopic stapler. The importance of this complication is to be conscious of its existence and its unclear clinical presentation, which may delay early surgical intervention, resulting in increased morbidity and mortality. The diagnosis can be established with an abdominal X-ray, which may show bowel dilation and fluid levels, abdominal ultrasound and CT scan, although the patient’s clinical status is the main figure of suspicion for this type of hernia. The treatment is surgical, by open or laparoscopic surgery with bowel resection and anastomosis, or primary closure. It is recommended the management of these complications, with a multidisciplinary approach.

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