Abstract
An 88-year-old woman who had no history of laparotomy and complained of vomiting and abdominal distention was referred to our hospital with a diagnosis of small bowel obstruction because an abdominal plain X-ray study showed dilated small bowel and air-fluid level formation at another hospital. Abdominal contrast-enhanced computed tomography showed a dilated small bowel situated right lateral to the cecum. She was diagnosed with small bowel obstruction and a long tube was placed to start conservative therapy. The abdominal symptoms improved, but the bowel obstruction persisted. Small bowel obstruction due to an internal hernia was suspected and on the 14th day after admission, laparoscopic surgery was performed. Operative findings revealed a lateral type of paracecal hernia. The hernia orifice was incised and opened to reduce the obstruction as well as to prevent recurrence with three-port laparoscopic surgery. The bowel could be kept intact.
In cases of internal hernias including paracecal hernias, preoperative diagnosis is relatively difficult and laparoscopic surgery may be useful for diagnosis and treatment.
