Post Roux-En-Y Gastric Bypass Lateral Port Site Hernia: Early Detection Prevents Lethal morbidity

Autor: Siddharth Sankar Das*, Sahil Navlani, Zaid AbdelAziz, Ferial A Mohamed Ali Abbas, Walid Zakaria A Mohd Bandook
Jazyk: angličtina
Rok vydání: 2022
Předmět:
DOI: 10.5281/zenodo.7509257
Popis: There has been a global increase in laparoscopic bariatric surgeries which has also increased the incidence of complications such as trocar site hernias wherein the fascia is not routinely closed. A 48 year old female with a BMI: 45.61 kg/m2 who underwent a laparoscopic RYGB returned on the 11th post op day with a complaint of pain and swelling on the left side of the abdomen. Physical examination findings showed a fluctuant tender swelling in the left lateral port site, suggestive of a seroma on ultrasound. CT scan abdomen showed fluid collection at the port site; drained using USG guided aspiration. The swelling reappeared the next day, repeat contrast CT abdomen suggested lateral port small bowel herniation. Emergency laparoscopy showed a congested jejunal loop herniating into the left lateral port which was reduced and closed. The patient recovered smoothly and was discharged after 2 days. A combination of early clinical suspicion, radiology findings and early operative intervention helped to prevent ischemia of the herniated segment of the jejunal loop. Bariatric surgeons should aim for closing the trocar sites to prevent such complications. Post-operative pain at the port site should raise suspicion and should validate the possibility of port site hernia and subsequent early intervention to reduce post-operative morbidity.
Databáze: OpenAIRE