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CASE REPORT
Adhesional small bowel obstruction related to stapling device from previous laparoscopic inguinal hernia repair
  1. Arnaldo Neves Santos Silva1,
  2. Efstratios Kouroumpas2,
  3. Nicola Fearnhead2 and
  4. Jonathan R Morton2
  1. 1 Department of Surgery, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
  2. 2 The Cambridge Colorectal Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
  1. Correspondence to Dr Arnaldo Neves Santos Silva, a.n.s.silva{at}doctors.org.uk

Abstract

Small bowel obstruction (SBO) is common surgical presenting problem, accounting for roughly 15 000 laparotomies per year in the UK. However, SBO post laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair is uncommon with an estimated incidence of 0.2%–0.5%. The common causes for SBO post-TAPP include inadequate closure, port-site herniation and adhesions. Here, we present a case of adhesional SBO related to stapling device from previous laparoscopic inguinal hernia repair and review alternative methods for mesh fixation. This case reports a rare but life-threatening complication from a commonly performed day case procedure and highlights importance of adequate surgical technique when inserting foreign bodies intra-abdominally. The patient required an emergency laparotomy and small bowel resection, developed postoperative ileus which managed with a nasogastric tube, intravenous fluids and parenteral nutrition and was discharged 12 days postoperatively.

  • gastrointestinal surgery
  • general surgery
  • surgery
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Footnotes

  • Contributors ANSS: wrote manuscript. EK: collected data and reviewed manuscript. NF: collected data and edited manuscript. JRM: operated on patient, collected photographs and reviewed manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.

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