Radiology Case Reports (Nov 2021)

Role of imaging in managing lateral trocar site incisional hernia after abdominoperineal resection

  • Karthigesu Aimanan, MD, MRCS, DrGenSurg,
  • Muhammad Ridzuan Mohd Nor, MBBCh,
  • Wong Ling, MBBS,
  • Khairunnisa Che Ghazali, MD, MMed (Surg),
  • Ahmad Junaidi Ahmad Hamidi, MD, MSurg (Gen Surg),
  • Firdaus Hayati, MD, DrGenSurg,
  • Zaidi Zakaria, MD, MMed (Surg),
  • Ismail Sagap, MBBCHBao, FRCS, MMed (Surg)

Journal volume & issue
Vol. 16, no. 11
pp. 3457 – 3460

Abstract

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Trocar site incisional hernia (TSIH) is an unpleasant complication of laparoscopic surgery. A 70-year-old male with low rectal carcinoma underwent a laparoscopic abdominoperineal resection after completion of neoadjuvant radiotherapy. The postoperative recovery was smooth; however, he developed abdominal distension and pain over the previous drain site after removal on day 3. In view of diagnostic ambiguity, an imaging tool was requested as an adjunct to further management. Computed tomography of the abdomen showed small bowel obstruction secondary to herniated ileal loops passing through the right iliac fossa anterior abdominal wall defect at the previous drainage site. An exploration was made and the rectus defect was closed using a non-absorbable suture.

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