Nihon Gekakei Rengo Gakkaishi (Journal of Japanese College of Surgeons)
Online ISSN : 1882-9112
Print ISSN : 0385-7883
ISSN-L : 0385-7883
A Case Report on a Small Bowel Obstruction Caused by a Lateral Type Paracecal Hernia
Ryota AokiShinichi HashimotoToshiyuki YamaguchiNobuo KomatsuMasahiro HayashiHiroshi Sakai
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2020 Volume 45 Issue 1 Pages 25-30

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Abstract

An 89-year-old woman was admitted for right abdominal pain and vomiting. Abdominal enhanced CT showed a poorly enhanced small intestine on the back of the cecum, and the cecum was forced to the medial side by the small intestine. We diagnosed the patient as having a strangulated small bowel obstruction due to a paracecal hernia. An emergency operation was performed. We found a hernia orifice on the lateral side of the cecum and a part of the ileum was incarcerated in this orifice. Therefore, we diagnosed the patient as having a small bowel obstruction caused by a lateral type paracecal hernia. We cut the upper edge of the hernia orifice and released the ileum. The incarcerated site of the ileum was necrotic, so we performed resection and anastomosis. We added an incision to the hernia orifice and opened it to prevent recurrence of the incarcerated hernia. The postoperative course was uneventful, and the patient was discharged on hospital day 21. Paracecal hernias have rarely been reported. Preoperative diagnosis of paracecal hernia is generally difficult and they often require emergency surgery. We report on this case with a review of the literature.

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© 2020 Japanese College of Surgeons
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