Abstract
We report a case of ileum resection assisted by laparoscopy for a subcutaneous abscess caused by a fistula between the ileum and the abdominal wall due to ileac impaction to a Spigelian hernia.
A 87-year-old man complained of digestive symptoms such as abdominal pain, diarrhea, vomiting, and anorexia from November 2009. However, the cause was remained undetermined. In February 2010, a left lower abdominal mass found during a checkup at another hospital. It was diagnosed as an abscess in the abdominal wall muscle layer and he was introduced to our hospital after an incision and drainage. After 17 days, it presented pus with a smell of feces, we diagnosed fistula from the ileum to the abdominal wall based on X-ray images. On day 24 of the disease, we performed laparoscopic surgery because the oral side ileum of the fistula remained expansive. Under laparoscopy, the lower left abdominal wall showed rigid impaction of the ileum, so we removed the intestine from the abscess cavity. In addition to the 5 cm for the laparotomy around the abscess wall, we performed a partial ileum resection. The recovery was uneventful, and he was discharged 11 days after the operation.
