Lesser sac hernia through the gastrocolic ligament 20 years post subtotal colectomy

2021 ◽  
Author(s):  
Jarrod Jolliffe ◽  
Matthew Stokes ◽  
Kenneth Buxey
Keyword(s):  
Subtotal Colectomy ◽  
Lesser Sac

scholarly journals Strangulated internal hernia through the lesser omentum with intestinal necrosis: a case report

2002 ◽  
Vol 120 (3) ◽  
pp. 84-86 ◽  
Author(s):  
Gustavo Gibin Duarte ◽  
Belchor Fontes ◽  
Renato Sérgio Poggetti ◽  
Marcos Roberto Loreto ◽  
Paulo Motta ◽  
...  
Keyword(s):  
Case Report ◽  
Intestinal Obstruction ◽  
Internal Hernia ◽  
Clinical Manifestations ◽  
Acute Intestinal Obstruction ◽  
Main Task ◽  
Intestinal Necrosis ◽  
Lesser Omentum ◽  
Lesser Sac ◽  
Internal Hernias

CONTEXT: Internal hernias account for only 0.2 to 0.9% of the cases of intestinal obstruction. They do not have specific clinical manifestations, and are usually diagnosed during laparotomy for acute intestinal obstruction. Internal hernias through the lesser omentum are extremely rare. CASE REPORT: We report here the case of a 36-year-old patient who underwent exploratory laparotomy for acute intestinal obstruction. An internal hernia through the lesser omentum was found, with a strangulated ileal segment passing through the perforation into an abscess within the lesser sac. The surgical procedures included ileal resection, primary anastomosis, abscess removal, and placement of a drain in the lesser sac. The patient was reoperated 6 days later for abdominal sepsis; a lesser sac abscess was removed and the abdominal incision was left open. The patient stayed in the Intensive Care Unit for 15 days, and eventually left the hospital on the 28th post-admission day, with complete recovery thereafter. CONCLUSION: The early diagnosis of acute intestinal obstruction and immediate indication for laparotomy is the main task of the surgeon when faced with a case of acute abdomen with a hypothesis of internal hernia, so as to minimize severe postoperative complications, as illustrated by the present case.

scholarly journals An Alternative Approach to the Terminal Management of Ogilvie Syndrome

2017 ◽  
Vol 11 (2) ◽  
pp. 352-358
Author(s):  
Daniel Galban ◽  
Joshua J. Baiel
Keyword(s):  
Quality Of Life ◽  
Surgical Resection ◽  
Medical Therapy ◽  
Subtotal Colectomy ◽  
Abdominal Discomfort ◽  
Conservative Approach ◽  
Replacement Surgery ◽  
Alternative Approach ◽  
Ogilvie Syndrome

Ogilvie syndrome is defined as colonic pseudo-obstruction due to nonmechanical causes. Mortality of nearly 50% is associated with perforation of the distended, pseudo-obstructed colon. While conservative medical therapy has proven to be beneficial in a majority of cases, >3% of patients have significant distention or perforation of the colon that warrants surgical resection. The case of a 48-year-old male with progressive abdominal discomfort and distention 12 days following knee replacement surgery is presented. He was subsequently diagnosed with colonic pseudo-obstruction and definitively treated with subtotal colectomy and colostomy. We propose that a more conservative approach to treatment of colonic pseudo-obstruction may prevent the need for colostomy, significantly improving quality of life.

scholarly journals Sevelamer-associated ischemic colitis with perforation

2015 ◽  
Vol 6 (1) ◽  
Author(s):  
Rachel Hudacko ◽  
Peter Kaye
Keyword(s):  
Ischemic Colitis ◽  
End Stage Renal Disease ◽  
Subtotal Colectomy ◽  
Bowel Necrosis ◽  
Drug Induced ◽  
Colonic Injury ◽  
Colonic Wall ◽  
Sevelamer Carbonate ◽  
Stage Renal Disease ◽  
End Stage

We present a case of an 83-year-old woman with end-stage renal disease and hyperphosphatemia treated with sevelamer carbonate, who underwent subtotal colectomy for diffuse bowel necrosis and two perforations in the transverse colon. Histologic examination revealed ischemic colitis with crystals consistent with sevelamer carbonate embedded in ulcer debris and within the colonic wall in areas of transmural necrosis. This is a novel cause of drug-induced ischemic colitis with subsequent perforation that has not yet been reported in the literature. Clinicians and pathologists should be aware of the potential complications of sevelamer use and the histologic features of sevelamer-induced colonic injury.

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