A case of small intestinal perforation due to sea tangle roll impaction revealed during laparoscopic surgery for a ruptured ovarian tumor

Abstract

  A 60-year-old woman was admitted to our hospital for lower abdominal pain, nausea, and vomiting. Computed tomography showed a 56-mm monolocular ovarian tumor with ascites. We determined this to be a case of ovarian tumor rupture and conducted emergent laparoscopic surgery. We observed a right ovarian tumor and yellowish-green ascites. We resected the tumor and collected intratumoral fluid, which was serous transparent. Its properties were differed from the ascites, which were present at the start of surgery. We suspected gastrointestinal perforation of the small intestine, with a foreign body. We partially resected the small intestine, which revealed an incarcerated sea tangle roll and small intestinal perforation. The patient's postoperative course was good and she was eventually discharged.

  Alimentary obstructions of the intestines are relatively rare and account for 0.3–1% of all intestinal obstructions. Intestinal obstructions due to sea tangle rolls account for 10–13% of alimentary bowel obstructions. This disease features acute stomach symptoms and can be difficult to diagnose. Because conservative treatment is often ineffective, and emergent surgery is often required, careful diagnosis is essential.