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.
CITATION STYLE
Lee, S. Y., Kim, C. H., Kim, Y. J., & Kim, H. R. (2017). Internal hernia following laparoscopic colorectal surgery: a rare but fatal complication. Hernia, 21(2), 299–304. https://doi.org/10.1007/s10029-016-1532-4
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