A Case of Serosal Injury of the Ileum After Repair of an Incarcerated Inguinal Hernia

Abstract

A 48-year-old man was brought to our hospital complaining of right lower abdominal pain. He was diagnosed as having an incarcerated right inguinal hernia, which was subsequently treated by hernia repair. Although the pain improved，the patient was admitted to our hospital because abdominal computed tomography (CT) revealed edema of the small intestine and a small amount of ascites. A repeat abdominal CT on the third postoperative day showed worsening of the small intestinal edema and increase in the amount of ascites, so we performed a review laparoscopy because of suspected peritonitis. The serosal injury noted on the mesenteric side of the ileum was considered to have possibly been caused during the repair of the incarcerated hernia, and we performed laparoscopic partial resection of the affected segment of the small intestine. As contamination of the abdominal cavity was mild, we used an anterior approach for the surgery. The patient showed a favorable clinical course and was discharged on the 10th postoperative day. Our case highlights the possibility of manual reduction of an inguinal hernia causing intestinal damage.