Iatrogenic internal hernia as a cause of small bowel ischemia during pregnancy

Ido Solt, David Kniaz, Arieh Eitan, Ella Ophir, Jacob Bornstein

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Internal hernia, a rare surgical complication, can cause intestinal obstruction. Pregnancy may complicate the timely clinical diagnosis. Case: A 39-year-old woman was referred at 28 weeks' gestation for diffuse abdominal pain and vomiting, 18 years after having had a jejunostomy. Abdominal ultrasonography showed dilated small bowel loops with thickening of the bowel wall to 7mm and free fluid in moderate amount. Laparotomy revealed an internal hernia with an incarcerated 1.5m necrotic distal small bowel. The necrotic bowel segment was resected en bloc and a side-to-side primary ileal anastomosis was performed. The hernial orifice at the mesointestine was sutured to prevent recurrence of bowel herniation. On the third postoperative day an urgent cesarean section was performed because of the onset of heavy vaginal bleeding subsequent to placental separation. Conclusions: Internal hernia should be included in the differential diagnosis of small bowel obstruction during pregnancy, especially when the clinical history includes previous abdominal operations. Early surgical exploration is important because of the risk of fetal and maternal morbidity and mortality.

Original languageEnglish
Pages (from-to)119-121
Number of pages3
JournalJournal of Gynecologic Surgery
Volume27
Issue number2
DOIs
StatePublished - 1 Jun 2011
Externally publishedYes

Bibliographical note

Funding Information:
This work was realized as a part of K4CARE project (IST-2004-026968) and the HYGIA project (TIN-2006-15453).

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