CLINICAL CASES   

Minerva Chirurgica 2006 April;61(2):167-9

Copyright © 2006 EDIZIONI MINERVA MEDICA

language: English

Small bowel evisceration after laparoscopic cholecystectomy: report of an unusual case

Baldassarre G. E. ¹, Valenti G. ¹, Torino G. ¹, Prosperi Porta I. ², Valenti V. ³, Campisi C. ⁴

¹ Department of General Surgery San Pietro Hospital-Fatebenefratelli, Rome, Italy 2 Department of Clinical Sciences Policlinico Umberto I La sapienza University, Rome, Italy 3 Department of Cardiology Sant’Andrea Hospital La sapienza University, Rome, Italy 4 National Research Council, Rome, Italy

With the rapid development of laparoscopic surgery particularly in cholecystectomy, despite its own advantages, an ever increasing number of reports describe the appearance of new pathologies, due to laparoscopic approach. Evisceration is a rare complication previously described in gynecological obstetric procedures and only once in laparoscopic cholecystectomy. The case of a small bowel evisceration after laparoscopic cholecystectomy in a patient with a multifactorial etiology is presented: weakness area in the umbilical region, intractable cough in the first postoperative day and disruptive tear of the fascia to remove 2 large-size stones. The conclusion is drawn that, according to the literature, holes greater than 5 mm in diameter should be closed at fascial level and we believe that the removal of the gallbladder from epigastric holes is important, in ordr to avoid an enlargement and rupture of the umbilical port.