Strangulated Bowel Obstruction Caused by Bowel Migration into the Space between the Exposed Structures after Pelvic Lymphadenectomy for Cervical Cancer

Abstract

A 49-year-old woman, with a history of extended hysterectomy and pelvic lymphadenectomy for stage IVB cervical cancer after preoperative chemotherapy, presented with abdominal pain during the course of postoperative chemoradiotherapy. Enhanced CT showed a strangulated loop of the small bowel below the right external iliac artery, for which emergency open surgery was performed. Intraoperative findings revealed that the small bowel had herniated into the space between the right external iliac artery, right ureter, and right umbilical artery. The strangulated small bowel had become ischemic and the small bowel was resected without injury to the structures that were exposed by prior pelvic lymphadenectomy. Here, we describe our experience with a case of small bowel strangulation caused by migration of the intestine into the space after pelvic lymphadenectomy, with a review of previous literature describing similar cases.