論文

査読有り 国際誌
2020年10月1日

Two-stage laparoscopic surgery for incarcerated umbilical Littre's hernia in severely obese patient: a case report.

Surgical case reports
  • Yu Ariyoshi
  • ,
  • Takayuki Suto
  • ,
  • Akira Umemura
  • ,
  • Hisataka Fujiwara
  • ,
  • Shingo Yanari
  • ,
  • Noriyuki Uesugi
  • ,
  • Tamotsu Sugai
  • ,
  • Akira Sasaki

6
1
開始ページ
245
終了ページ
245
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1186/s40792-020-01008-3

BACKGROUND: Littre's hernia containing Meckel's diverticulum is an extremely rare disease. We report an adult case of two-stage laparoscopic surgery for incarceration of Meckel's diverticulum in an umbilical hernia. CASE PRESENTATION: The case involved a 23-year-old, severely obese man with BMI 36.5 kg/m2. After experiencing effusion from the umbilicus for 2 months, and was referred from a local dermatologist. We diagnosed an infected urachal remnant, and antibiotic therapy was performed first. Surgery was planned for after the infection disappeared. During follow-up, effusion from the umbilicus took on an intestinal fluid-like character, so we diagnosed small intestinal cutaneous fistula and performed surgery. Under laparoscopy, we found a Meckel's diverticulum incarcerated in an umbilical hernia. The diverticulum was resected first, and the incarceration was released. The umbilicus was infected, so we planned repair of the umbilical hernia in a second surgery. The postoperative course was uneventful and the patient was discharged on postoperative day 5. One month after the initial operation, we confirmed that there were no signs of infection, and performed umbilical hernia repair using the laparoscopic intraperitoneal onlay mesh (IPOM) repair. Postoperative progress was uneventful and he was discharged on postoperative day 4. No recurrence or infection was observed until 8 months postoperatively. CONCLUSIONS: We performed dissection of the diverticulum and umbilical hernia repair for the incarcerated umbilical Littre's hernia under laparoscopy in a severely obese patient. The risk of mesh infection seems to be avoidable using a two-stage surgery, and the risk of recurrence can be reduced using the IPOM repair compared with simple suture closure.

リンク情報
DOI
https://doi.org/10.1186/s40792-020-01008-3
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/33000336
PubMed Central
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7527395

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