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Case report
Strangulated small bowel obstruction complicating totally extra-peritoneal laparoscopic inguinal hernia repair
  1. Mohammed Al-Zubaidi,
  2. Nicholas Bayfield and
  3. Shelbin Neelankavil
  1. General Surgery, Rockingham General Hospital, Cooloongup, Western Australia, Australia
  1. Correspondence to Dr Mohammed Al-Zubaidi; mohammed_az1985{at}


Totally extraperitoneal (TEP) laparoscopic inguinal hernia repair is a surgical method of inguinal hernia repair that avoids entry into the peritoneum, thus significantly reducing likelihood of intra-peritoneal complications. Herein, we describe a rare case in which a 42-year-old man presented with acutely strangulated small bowel in an internal hernia through the peritoneum and posterior rectus sheath 6 days postelective TEP laparoscopic inguinal hernia repair. He presented with acute onset severe abdominal pain and intractable vomiting. After CT diagnosis, emergent laparotomy was performed, and 20 cm of non-viable small bowel required resection, with enteric anastomosis. The peritoneal defect was identified and repaired. The patient was discharged 4 days postoperatively with an uneventful postoperative course.

  • general surgery
  • gastrointestinal surgery
  • radiology
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  • Contributors All authors gave substantial contributions to complete the this report at different levels. MA played a major role in consenting the patient, designing the work, collecting and analysing the data, drafting the work, submitting the report and following up the patient. NB played a crucial role in revising the data, revision of the draft and collecting photos of the procedure. SN was the supervisor, who initiated the idea of reporting this case, delivered great guidance in writing the report and played the main role in the approval of the version published.

  • 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.

  • Patient consent for publication Obtained.

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

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