PT  - JOURNAL ARTICLE
AU  - Martina Spazzapan
AU  - Roberta Bullingham
AU  - Nkwam Michael Nkwam
AU  - Efthymios Ypsilantis
TI  - Paraureteric space post-ureteric re-implantation: a rare cause of small bowel obstruction
AID  - 10.1136/bcr-2022-252356
DP  - 2022 Dec 01
TA  - BMJ Case Reports
PG  - e252356
VI  - 15
IP  - 12
4099  - http://casereports.bmj.com/content/15/12/e252356.short
4100  - http://casereports.bmj.com/content/15/12/e252356.full
SO  - BMJ Case Reports2022 Dec 01; 15
AB  - A female patient in her 80s presented with a 2-day history of abdominal pain and absolute constipation, having previously undergone a robotic left distal ureterectomy with ureteric re-implantation. CT revealed a closed-loop small bowel obstruction with transition point adjacent to the left ureter and resultant upstream hydronephrosis. An emergency laparotomy revealed small bowel herniation into a paraureteric space created by her previous surgery and defined by the distal ureter medially, the common iliac vessels laterally and the mobilised bladder dome anteriorly. The viable small bowel was reduced, and the space was eliminated by omental flap transposition after omentoplasty. The patient made a full recovery. Preoperative diagnosis of such an unusual cause of internal herniation can be challenging. This very rarely reported case raises awareness of the condition and proposes a treatment strategy.