Paraureteric space post-ureteric re-implantation: a rare cause of small bowel obstruction.

Autor:	Spazzapan M; Princess Royal University Hospital, Department of Surgery, King's College Hospital NHS Foundation Trust, London, UK martina.spazzapan@nhs.net., Bullingham R; Princess Royal University Hospital, Department of Surgery, King's College Hospital NHS Foundation Trust, London, UK., Nkwam NM; Urology, King's College Hospital NHS Foundation Trust, London, UK., Ypsilantis E; Princess Royal University Hospital, Department of Surgery, King's College Hospital NHS Foundation Trust, London, UK.
Jazyk:	angličtina
Zdroj:	BMJ case reports [BMJ Case Rep] 2022 Dec 30; Vol. 15 (12). Date of Electronic Publication: 2022 Dec 30.
DOI:	10.1136/bcr-2022-252356
Abstrakt:	A female patient in her 80s presented with a 2-day history of abdominal pain and absolute constipation, having previously undergone a robotic left distal ureterectomy with ureteric re-implantation. CT revealed a closed-loop small bowel obstruction with transition point adjacent to the left ureter and resultant upstream hydronephrosis. An emergency laparotomy revealed small bowel herniation into a paraureteric space created by her previous surgery and defined by the distal ureter medially, the common iliac vessels laterally and the mobilised bladder dome anteriorly. The viable small bowel was reduced, and the space was eliminated by omental flap transposition after omentoplasty. The patient made a full recovery. Preoperative diagnosis of such an unusual cause of internal herniation can be challenging. This very rarely reported case raises awareness of the condition and proposes a treatment strategy. Competing Interests: Competing interests: None declared. (© BMJ Publishing Group Limited 2022. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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