Open AccessMechanical intestinal obstruction following laparoscopic inguinal hernia repair in a patient with abdominal cocoon syndrome
Author(s) -
Geon Hi Park,
Byoung Chul Lee,
Dong Choon Hyun,
Jun Shik Choi,
Young Mok Park,
Hyuk Jung,
Hong Jae Jo
Publication year - 2019
Publication title -
journal of surgical case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.14
H-Index - 3
ISSN - 2042-8812
DOI - 10.1093/jscr/rjz370
Subject(s) - medicine , bowel obstruction , inguinal hernia , surgery , small intestine , emergency department , anastomosis , abdominal cavity , laparoscopy , peritoneal cavity , hernia , bowel resection , psychiatry
Abdominal cocoon syndrome (ACS) is a rare condition characterized by partial or complete encasement of small intestine by a thick fibro-collagenous membrane. A 65-year-old man presented to the surgical department with left inguinal. He underwent laparoscopic transabdominal preperitoneal inguinal hernia. When we inserted a trocar into the peritoneal cavity, the small intestine was injured and repaired immediately. We identified a fibrotic membrane covering the small intestine, which was found as ACS. Two weeks later after discharge, he presented to the emergency department with mechanical intestinal obstruction. Conservative treatment had no effect on the patient and membrane excision, adhesiolysis and small intestine resection with anastomosis were performed. Unfortunately, the patient was hospitalized for a long time with bowel leakage and discharged on postoperative day 48. The preoperative diagnosis is quite challenging and most cases are diagnosed intraoperatively. When finding the ACS during the operation, careful attention should be needed.