Laparoscopic Management of Early Post operative Small Bowel Adhesive Obstruction following Hysterectomy: a Series of 2 Cases:(IGWHC)-Lupine Publishers
Laparoscopic Management of Early Post operative Small Bowel Adhesive Obstruction following Hysterectomy: a Series of 2 Cases by D Kavitha Yogini in IGWHC in Lupine Publishers
Objective: To describe laparoscopic management of two cases of early post operative small bowel obstruction. One case that occurred after
a total laparoscopic hysterectomy with uterosacral colpopexy and the second case following vaginal hysterectomy.
Design: Case series
Setting: Academic Medical and Research Centre.
Patient: We report a 50 year old woman who developed small
bowel obstruction five days after total laparoscopic hysterectomy with
bilateral salpingo oophorectomy and uterosacral colpopexy due to
adhesion of an ileal loop to the vaginal vault. The second patient
presented
ten days after vaginal hysterectomy with symptoms of bowel obstruction
Intervention: Both patients were managed conservatively for 48
hours with bowel rest and intravenous hydration. Due to unsatisfactory
recovery of clinical symptoms and supportive radiologic findings,
diagnostic laparoscopy was performed. The adherent ileal loop was
released
by blunt dissection in both the cases. Immediate clinical improvement
was seen during post operative period.
Main Outcome MeasureClinical resolution of small bowel obstruction symptoms.
Result:No bowel resection was needed.
Conclusion: Adhesive small bowel obstruction can occur in the
immediate post operative period and can be managed laparoscopic ally.
It can occur following laparoscopic and vaginal hysterectomy in low risk
patients and should be borne in mind when evaluating symptoms of
small bowel obstruction in these patients.
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