Case Report: Intestinal obstruction secondary to an internal hernia following Lichtenstein hernia repair

Abstract

Introduction: Inguinal hernias are usually treated with surgical repair. Intestinal obstruction immediately after inguinal hernia repair is rare. This report describes a case of intestinal obstruction due to an internal hernia after a Lichtenstein hernia repair. Case: An 80-year-old male presented with intestinal obstruction and underwent a Lichtenstein repair of a right inguinal hernia. On the 5th postoperative day, he developed recurrent obstructive symptoms not improving with nonoperative management, and surgery was undertaken. On entering the peritoneal cavity, the small intestine was herniated through a peritoneal defect in the right lateral inguinal fossa. Absorbable adhesion barrier (INTERCEED®) was applied at site of the defect after laparoscopic resolution of intestinal obstruction. The patient has had no evidence of recurrence 4 months post-operation. Discussion: The original inguinal hernia was repaired by the Lichtenstein technique, but intestinal obstruction developed postoperatively, which laparoscopy revealed to be an internal hernia. Preperitoneal hernia as a postoperative complication may have occurred due to peritoneal defect. Intraoperative placement of absorbable adhesion barrier at the site of the resected peritoneal defect may help prevent recurrence.departmental bulletin pape