Abstract
A 45-year-old woman who underwent surgery for uterine cancer 2 weeks earlier developed vomiting and abdominal pain on the 4th postoperative day. Physical examination showed slight abdominal distention and mild tenderness on the right side of the median line. A gynecologist diagnosed the case as postoperative adhesive intestinal obstruction and prescribed conservative treatment for 11 days. Abdominal computed tomography images taken on the 15th postoperative day showed strangulated ileus and right hydronephrosis ; emergency reoperation was performed on the same day. The Treitz ligament was not found in the normal location but was present on the right side of the vertebra, so that malrotation was diagnosed. The small intestine was considered to have invaginated into a space between the right ureter which had been isolated during the hysterectomy and the retroperitoneum, at where the small intestine was strangulated. After successful relief of the strangulation of the small intestine, the right ureter was sutured to the retroperitoneum to prevent recurrence. No bowel resection was needed. We herein report a rare case of strangulated ileus caused by the ureter after radical hysterectomy, together with a review of the literature.
