Rare Cause of Intestinal Obstruction After Laparoscopic Radical Nephrectomy: Internal Herniation via a Mesenteric Defect

A 43-year-old man had painless macroscopic hematuria and was diagnosed with a 9-cm renal carcinoma in the lower pole of the left kidney. He underwent laparoscopic transperitoneal left radical nephrectomy (LRN) with an uneventful recovery. Eleven days later, he developed intestinal obstruction (IO)....

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Bibliographic Details
Published in:Urology (Ridgewood, N.J.) N.J.), 2008-09, Vol.72 (3), p.716.e13-716.e14
Main Authors: Wong, Joelle F.S, Ho, Henry S.S, Tan, Y.H, Cheng, Christopher W.S
Format: Article
Language:English
Subjects:
Adult
Carcinoma, Renal Cell - complications
Carcinoma, Renal Cell - surgery
Hematuria - diagnosis
Hernia - etiology
Humans
Intestinal Obstruction - etiology
Intestinal Obstruction - pathology
Kidney - pathology
Kidney Neoplasms - complications
Kidney Neoplasms - surgery
Laparoscopy - adverse effects
Male
Mesentery - pathology
Nephrectomy - adverse effects
Urology
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Summary:A 43-year-old man had painless macroscopic hematuria and was diagnosed with a 9-cm renal carcinoma in the lower pole of the left kidney. He underwent laparoscopic transperitoneal left radical nephrectomy (LRN) with an uneventful recovery. Eleven days later, he developed intestinal obstruction (IO). Abdominal computed tomography scan showed dilated small bowels occupying the left renal fossa. Laparotomy revealed closed-loop small bowel obstruction resulting from internal intestinal herniation via a 5-cm mesenteric defect. It was repaired after the herniated bowels were reduced. This case illustrates a rare cause of IO after LRN, in which mesenteric defect is necessary.
ISSN:0090-4295
1527-9995
DOI:10.1016/j.urology.2007.12.028