Findings: Internal hernia through mesenteric defect created by jump graft
Description of Procedure:
A 10 blade was used to make a midline incisison . The soft tissues were divided using electrocautery, being careful to maintain hemostasis as the dissection proceeded. We inmediatedly identified upon reaching the abdomen a distended proximal small bowel that was herniating through a defect created between the SMV jump graft that provide a portal vein inflow to the transplanted liver and her mesentery. We Carefully release the incarcetrated bowel and untwisted to correct its natural curvature.
We were able to improve flow to the bowel . No evidence of discoloration or lack of perfusion were noticed. Since there was no need to performed a bowel resection at this point, We irrigated profusely the abdominal cavity.
The wound was irrigated. The fascia was closed using a number 1 PDS suture following with internal retention sutures. The skin was closed with a staples . A sterile island bandage was applied. The sterile drapes were removed and the patient remained intubated and transferred to the Intensive Care Units unit in stable condition for further monitoring.