A Case of Intestinal Obstruction Secondary to Adhesions after Transabdominal Preperitoneal Bilateral Inguinal Herniorrhaphy

Abstract

We report a case of adhesive intestinal obstruction after transabdominal preperitoneal (TAPP) surgery. A 75-year-old man presented to our hospital because of abdominal distention one month after bilateral inguinal herniorrhaphy. Contrast-enhanced computed tomography revealed intestinal obstruction due to incarcerated small bowel in the Retzius cavity and adhesions between the small bowel and the mesh. We inserted a nasal ileal tube, but symptoms did not resolve after 7 days. Therefore, we performed adhesiolysis between the small bowel and the mesh, followed by closure of the Retzius cavity to prevent recurrent bowel obstruction. On postoperative day 7, the patient presented with a subcutaneous abscess, which we drained and treated with antibiotics. He was discharged on postoperative day 19. The possibility of adhesive intestinal obstruction after TAPP should be considered.