RT Journal Article
SR Electronic
T1 Paraureteric space post-ureteric re-implantation: a rare cause of small bowel obstruction
JF BMJ Case Reports
JO BMJ Case Reports
FD BMJ Publishing Group Ltd
SP e252356
DO 10.1136/bcr-2022-252356
VO 15
IS 12
A1 Martina Spazzapan
A1 Roberta Bullingham
A1 Nkwam Michael Nkwam
A1 Efthymios Ypsilantis
YR 2022
UL http://casereports.bmj.com/content/15/12/e252356.abstract
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.