Small bowel obstruction - port site hernia

Case contributed by Dr Henry Knipe

Presentation

Three days post sleeve gastrectomy and left inguinal hernia repair. Abdominal distension and pain.

Patient Data

Age: 50 years
Gender: Female

Distension of the small bowel with air-fluid levels. Right lower anterior abdominal wall hernia containing small bowel and is also the transition point to collapsed bowel. Post-surgical change within the anterior abdominal wall and left inguinal region.

Case Discussion

The hernia was through a previous laparoscopic port site. The patient returned to theater, the hernia was successfully reduced and the port site closed. The main differential is a Spigellian hernia, although on close inspection the defect appears just a lateral to the semilunar line. 

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