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Laparoscopy-assisted repair for small intestinal perforation in the inguinal hernia sac caused by minor blunt abdominal trauma : A case report Yosuke KOBAYASHI 1 , Naoyuki OKA 1 , Masanori ODAIRA 1 , Fumiki TORIUMI 1 , Takashi ENDO 1 , Hirohisa HARADA 1 1Department of Surgery, Tokyo Saiseikai Central Hospital Keyword: 腹部打撲 , 鼠径ヘルニア , 小腸穿孔 pp.129-135
Published Date 2021/3/15
DOI https://doi.org/10.11477/mf.4426200887
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 A 68-year-old woman, who had been aware of left inguinal bulging, was transported to our hospital because of nausea and hematemesis after she fell while walking. There was no remarkable abdominal tenderness although she felt nausea. Computed tomography showed free air in the upper abdomen and thickened gastric wall. A left-sided direct inguinal hernia was also detected, but there was no intestinal incarceration. Emergency laparoscopic surgery was performed for the suspected gastric perforation ; a 1-cm perforation was found in the small intestine near the left groin hernia but not in the stomach. Food residue was present inside the groin hernia sac, and so we presumed that the fall caused small intestinal perforation inside the sac. We trimmed the periphery of the perforated area and sutured it closed. She was discharged with no problem and underwent laparoscopic transabdominal preperitoneal repair 1 month later. This rare case suggested that the small intestinal perforation can be caused by pressure differences inside a hernia sac in association with a sudden increase in abdominal pressure caused by a fall.


Copyright © 2021, JAPAN SOCIETY FOR ENDOSCOPIC SURGERY All rights reserved.

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電子版ISSN 2186-6643 印刷版ISSN 1344-6703 日本内視鏡外科学会

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