Published online Apr 16, 2025. doi: 10.12998/wjcc.v13.i11.98570
Revised: October 28, 2024
Accepted: December 6, 2024
Published online: April 16, 2025
Processing time: 179 Days and 0.2 Hours
Internal hernia is a rare complication following abdominal surgery, primarily resulting from structural defects caused by anastomosis. We report a unique case of a late abdominal wall internal hernia highly suspected as resulting from insu
A 72-year-old woman presented with symptoms of intestinal obstruction 40 years after undergoing an abdominal hysterectomy. Abdominal computed tomography revealed a suspicious closed loop of intestine; then, a laparotomy was performed for suspected internal hernia. During the procedure, herniation of intestine into the preperitoneal space through a parietal peritoneal defect between rectus abdominis and sigmoid colon was identified. Intestinal reduction, resection of the ischemic segment and closure of the peritoneal defect were performed. The patient recovered well.
Non-closure of peritoneum might lead to late internal hernias. Meticulous peritoneal closure should be considered to prevent this potentially lethal complication.
Core Tip: We report a unique case of an abdominal wall internal hernia, a late complication that is highly suspected to be related to insufficient peritoneal closure. In the context of the current dominant practice of not closing the peritoneum, our case highlights a potential challenge in lower abdominal surgeries, particularly those involving organ resection or transabdominal preperitoneal inguinal herniorrhaphy. It emphasizes the need for heightened awareness among clinicians regarding long-term surgical outcomes, and advocates for meticulous peritoneal closure to prevent this potentially lethal issue, despite the limited existing evidence.