J Acute Care Surg.  2022 Nov;12(3):138-141. 10.17479/jacs.2022.12.3.138.

A Case of Preperitoneal Herniation of the Small Bowel Causing Intestinal Obstruction Following a Totally Extra Peritoneal Hernia Repair

• Samarakoon LB
• Chandraprakash S
• Fernandes R
• Basnyat P

• KMID: 2536169
• DOI: http://doi.org/10.17479/jacs.2022.12.3.138

Abstract

Preperitoneal hernia is a very rare complication following laparoscopic inguinal hernia repair. A 57-yearold male underwent a right inguinal hernia totally extra peritoneal repair on 20/10/2021. Initial recovery was uncomplicated but on post operative day 10, he developed sudden onset of vomiting and abdominal pain. Initial imaging showed small bowel obstruction with a possible transition point. An internal hernia was suspected and he was offered urgent diagnostic laparoscopy following counseling. A preperitoneal defect was noted with distended proximal ileum and collapsed distal ileum and colon. A small bowel runthrough did not reveal any pathological abnormalities. A presumptive diagnosis of a preperitoneal hernia was made, and the defect was closed with a running V lock suture. The patient made an uneventful postoperative recovery. An inadvertent breach in the peritoneum during a totally extra peritoneal repair can lead to preperitoneal herniation of the small bowel and intestinal obstruction postoperatively.

Keyword

laproscopic TEP repair; peritoneal defect; preperitoneal hernia