A Case of Strangulated Bowel Obstruction Caused by the Left External Iliac Artery After Prostate Cancer Surgery

Abstract

A 71-year-old man who had undergone a robot-assisted radical prostatectomy for prostate cancer two years ago visited our emergency department complaining of having developed lower abdominal pain after a meal. Contrast-enhanced abdominal CT showed strangulated small bowel obstruction, and urgent laparotomy was performed. The small bowel was incarcerated in the gap between the left external iliac artery and the retroperitoneum, which was exposed by dissection during the previous surgery. We resected the strangulated bowel without injuring the left external iliac artery and performed a functional end-to-end anastomosis. In order to prevent the recurrence, we closed the outer membrane of the left external iliac artery and the retroperitoneum with non-absorbable sutures. The postoperative course was uneventful, and the patient was discharged on the 11th postoperative day. Few cases of strangulated bowel obstruction caused by incarceration of the small intestine between the external iliac artery and the retroperitoneum have been reported. Herein, we report this rare case with a review of the literature.