Two-stage laparoscopic surgery for incarcerated umbilical Littre’s hernia in severely obese patient: a case report
Abstract 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 o...
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Japan Surgical Society
2020-10-01
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| Series: | Surgical Case Reports |
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| Online Access: | http://link.springer.com/article/10.1186/s40792-020-01008-3 |
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| author | Yu Ariyoshi Takayuki Suto Akira Umemura Hisataka Fujiwara Shingo Yanari Noriyuki Uesugi Tamotsu Sugai Akira Sasaki |
| author_facet | Yu Ariyoshi Takayuki Suto Akira Umemura Hisataka Fujiwara Shingo Yanari Noriyuki Uesugi Tamotsu Sugai Akira Sasaki |
| author_sort | Yu Ariyoshi |
| collection | DOAJ |
| description | Abstract 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. |
| format | Article |
| id | doaj-art-b1ffe3342bbd41b0b34ee3fb08a70c03 |
| institution | Kabale University |
| issn | 2198-7793 |
| language | English |
| publishDate | 2020-10-01 |
| publisher | Japan Surgical Society |
| record_format | Article |
| series | Surgical Case Reports |
| spelling | doaj-art-b1ffe3342bbd41b0b34ee3fb08a70c032025-08-20T03:36:02ZengJapan Surgical SocietySurgical Case Reports2198-77932020-10-01611710.1186/s40792-020-01008-3Two-stage laparoscopic surgery for incarcerated umbilical Littre’s hernia in severely obese patient: a case reportYu Ariyoshi0Takayuki Suto1Akira Umemura2Hisataka Fujiwara3Shingo Yanari4Noriyuki Uesugi5Tamotsu Sugai6Akira Sasaki7Department of Surgery, Morioka Municipal HospitalDepartment of Surgery, Morioka Municipal HospitalDepartment of Surgery, Iwate Medical University School of MedicineDepartment of Surgery, Morioka Municipal HospitalDepartment of Surgery, Morioka Municipal HospitalDepartment of Molecular Diagnostic Pathology, Iwate Medical University School of MedicineDepartment of Molecular Diagnostic Pathology, Iwate Medical University School of MedicineDepartment of Surgery, Iwate Medical University School of MedicineAbstract 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.http://link.springer.com/article/10.1186/s40792-020-01008-3Meckel’s diverticulumUmbilical herniaLittre’s herniaLaparoscopic hernia repairIntraperitoneal onlay mesh (IPOM) |
| spellingShingle | Yu Ariyoshi Takayuki Suto Akira Umemura Hisataka Fujiwara Shingo Yanari Noriyuki Uesugi Tamotsu Sugai Akira Sasaki Two-stage laparoscopic surgery for incarcerated umbilical Littre’s hernia in severely obese patient: a case report Surgical Case Reports Meckel’s diverticulum Umbilical hernia Littre’s hernia Laparoscopic hernia repair Intraperitoneal onlay mesh (IPOM) |
| title | Two-stage laparoscopic surgery for incarcerated umbilical Littre’s hernia in severely obese patient: a case report |
| title_full | Two-stage laparoscopic surgery for incarcerated umbilical Littre’s hernia in severely obese patient: a case report |
| title_fullStr | Two-stage laparoscopic surgery for incarcerated umbilical Littre’s hernia in severely obese patient: a case report |
| title_full_unstemmed | Two-stage laparoscopic surgery for incarcerated umbilical Littre’s hernia in severely obese patient: a case report |
| title_short | Two-stage laparoscopic surgery for incarcerated umbilical Littre’s hernia in severely obese patient: a case report |
| title_sort | two stage laparoscopic surgery for incarcerated umbilical littre s hernia in severely obese patient a case report |
| topic | Meckel’s diverticulum Umbilical hernia Littre’s hernia Laparoscopic hernia repair Intraperitoneal onlay mesh (IPOM) |
| url | http://link.springer.com/article/10.1186/s40792-020-01008-3 |
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