2022 Volume 42 Issue 1 Pages 37-39
A 74-year-old man with sigmoid colon cancer was referred to us for surgical treatment. We performed laparoscopic sigmoid colectomy without intraoperative complications, and the patient resumed oral intake on the third postoperative day. However, he developed vomiting on the fifth postoperative day. Abdominal contrast-enhanced computed tomography revealed upper bowel obstruction due to internal herniation of the intestine via a large mesenteric defect measuring about 12 cm in diameter. Exploratory laparoscopy and repositioning was performed. Laparoscopic observation showed herniation of a 50-cm segment of the small intestine near Treitz’s ligament through the mesenteric defect into the left side of the abdomen. We repositioned the small intestine, with suturing at two points（left upper part of the descending colon and left lower part of the mesentery）. The abdominal symptoms improved after surgery and the patient was discharged from the hospital on the seventh day after the second surgery.
