Internal Hernia Following Laparoscopic Colorectal Surgery: a Rare but Fatal Complication

Overview

Journal Hernia

Publisher Springer

Date 2016 Sep 3

PMID 27585804

Citations 6

Authors

S Y Lee

C H Kim

Y J Kim

H R Kim

Affiliations

Soon will be listed here.

Abstract

Purpose: Internal hernia of the small bowel through a mesenteric defect following colorectal cancer surgery is a serious but rarely reported complication. The aim of this study was to evaluate the incidence, clinical features, and management of these hernias.

Methods: We retrospectively reviewed 4589 primary colorectal cancer patients who underwent surgical resection between January 2007 and December 2015. The incidence, clinical presentations, and short-term outcomes of patients with symptomatic internal hernia following colorectal surgery were investigated in detail.

Results: We found 9 (0.2 %) patients who presented with symptomatic internal hernia. In all cases, preceding surgical procedures were laparoscopic anterior resection (n = 9), including low anterior resection (n = 3) and intersphincteric resection (n = 3). The median time interval between initial surgery and the occurrence of internal hernia was 4 months (range 5 days-27 months). Main symptoms were abdominal distension and pain; 4 (44.4 %) patients presented with systemic inflammatory response syndrome. Most cases (7/9, 77.8 %) were suspected of internal hernia by preoperative abdominal computed tomography. Six (66.6 %) patients underwent emergency surgery, after which all developed postoperative complications without mortality. The median hospital stay was 27.5 days (range 25-54 days) among patients who underwent surgical intervention.

Conclusions: Internal hernia following colorectal cancer surgery is a rare but potentially fatal complication, and as such, early recognition and management of these cases are important.

Citing Articles

Risk factors of symptomatic internal hernias after left hemicolectomy: a multicenter retrospective study.

Yin S, Li H, Xu J, Chen A, Di M, Hu X Surg Endosc. 2025; .

PMID: 39920374 DOI: 10.1007/s00464-025-11534-6.

High prevalence of asymptomatic internal hernias after laparoscopic anterior resection in a retrospective analysis of postoperative computed tomography.

Daster S, Xiang H, Yang J, Rowe D, Keshava A, Rickard M Int J Colorectal Dis. 2020; 35(5):929-932.

PMID: 32095872 DOI: 10.1007/s00384-020-03537-7.

A cross sectional study to investigate internal hernia post left-sided colectomy preserving superior rectal artery.

Taira T, Murono K, Nozawa H, Hojo D, Kawai K, Hata K Ann Med Surg (Lond). 2019; 48:124-128.

PMID: 31763040 PMC: 6864359. DOI: 10.1016/j.amsu.2019.10.026.

Closure of the retroperitoneal space in laparoscopic anterior resection with FLEXDEX™.

Khan M, Murphy E, Moynihan A, Cahill R Tech Coloproctol. 2019; 23(12):1177-1178.

PMID: 31754978 DOI: 10.1007/s10151-019-02118-3.

Internal hernia after laparoscopic colorectal surgery: an under-reported potentially severe complication. A systematic review and meta-analysis.

Portale G, Popescu G, Parotto M, Cavallin F Surg Endosc. 2019; 33(4):1066-1074.

PMID: 30680656 DOI: 10.1007/s00464-019-06671-8.

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