腹腔鏡下に整復したS状結腸間膜窩ヘルニアによる絞扼性イレウスの一例

Abstract

A 50-year-old woman visited our hospital in emergency because of sudden lower abdominal pain. There was tenderness in the left lower abdomen. An abdominal computed tomography scan showed a loop-shaped small bowel in the left lower abdomen. A strangulated ileus due to an internal hernia was diagnosed and emergency laparoscopic surgery was performed 21 hours after the onset of symptoms. The laparoscopic findings showed that the small bowe1 had herniated into the intersigmoid fossa. We diagnosed intersigmoid hernia. The incarceration was reduced by laparoscopic maneuver. Since the incarcerated portion of the small bowel was viable, we did not remove it. The postoperative course was uneventful. The patient was discharged from our hospital on the fifth day after surgery and we followed the patient 47 days after surgery. Intersigmoid hernia is very rare. We report our experience of successful laparoscopic diagnosis and treatment for intersigmoid hernia along with a literature revlew.