Mesocolic hernia following retroperitoneal laparoscopic radical nephrectomy: A case report

Transmesenteric internal hernia: an unexpected adverse event induced by colonoscopy

Transmesenteric internal hernia is an uncommon cause of small bowel obstruction that occurs when small bowel loops protrude through a mesenteric defect into the abdominal cavity. Herein, we present an unexpected case of colonoscopy-induced transmesenteric internal hernia. An 81-year-old male patient presenting with intermittent hematochezia and constipation had undergone a laparoscopic left nephrectomy for ureteral cancer. A colonoscopy was performed to identify the etiology of his symptoms. He complained of severe abdominal pain 2 h after the examination despite uneventful endoscopic procedures, including cold snare polypectomy. Contrast-enhanced computed tomography revealed a strangulated small bowel obstruction with a closed-loop formation outside the descending colon. The small bowel loop was incarcerated into the left retroperitoneal space. Emergency laparotomy detected small bowel loops that prolapsed into the nephrectomy pedicle via a descending mesenteric defect, developed during the laparoscopic left nephrectomy. The incarcerated small bowel was detached from the hernia and returned to its normal position, and the mesenteric defect was closed. He demonstrated an uneventful postoperative course, with no internal hernia recurrence after discharge. This case indicates the risk of transmesenteric internal hernia through inadvertently created mesenteric defects should be borne in mind, especially when performing colonoscopies in patients who underwent laparoscopic nephrectomies.

A spontaneous paracecal herniation: a rare form of an uncommon case

Paracecal hernias are a rare form of internal hernias. This is a case of a spontaneous paracecal retroperitoneal hernia in an elderly patient. A 73-year-old male, a known patient of adenocarcinoma of the rectum, who had undergone neoadjuvant radiotherapy and chemotherapy a year ago, presented with a 2-day-history of exacerbated colicky peri-umbilical and right-sided non-radiating abdominal pain, with associated progressive abdominal distension, which were aggravated by feeding. A contrasted abdominal computed tomography scan showed features of small bowel obstruction. An exploratory laparotomy revealed herniation of gangrenous small bowel ~30 cm through a small, tight opening just below the base of the cecum. Resection and anastomosis and closure of the retroperitoneal pouch were done. Patient recovered and was discharged on the fourth post-operative day. Spontaneous retroperitoneal hernias can occur in elderly patients with additional risk factors like neoplasms, with a high risk of bowel ischemia, hence the urgent need for surgical intervention.

Clinical Effect of Retroperitoneal Laparoscopic Radical Nephrectomy on Renal Cell Carcinoma, the Influence of Renal Function, and the Influencing Factors of Recurrence

Renal cell carcinoma is abbreviated as renal carcinoma, and its clinical symptoms are basically hematuria, lumbago, and abdomen bump. As people's lifestyles change, the incidence of renal carcinoma continues to rise due to factors such as smoking and obesity. At present, surgical treatment is mostly used in clinical practice. Traditional open radical nephrectomy (ORN) is one of the main methods for clinical treatment of renal carcinoma. However, due to its large wound and large amount of intraoperative blood loss, the renal function of patients after surgery is poor, which is not conducive to the postoperative recovery of patients. Retroperitoneal laparoscopic radical nephrectomy (RLRN) has been widely used in the surgical treatment of renal cancer due to its advantages of small wound, less bleeding, and rapid recovery. The purpose of this study was to investigate the efficacy of RLRN in the treatment of renal cancer patients and its effect on renal function and to analyze the related factors affecting postoperative recurrence of patients. We adopt ORN and RLRN, two kinds of treatment, in patients with renal cancer surgery way, contrast analysis of the two groups of operation time, intraoperative blood loss, postoperative intestinal function recovery time, drainage tube indwelling time, length of hospital stay, and other clinical indicators and renal function indexes and use the single factor analysis and multifactor analysis, the relevant factors that affect kidney cancer patients with postoperative recurrence. The results showed that, compared with ORN treatment, RLRN treatment of renal cancer patients has a short operation time, less trauma, quick recovery after surgery, and fewer complications and can effectively alleviate the renal function injury and the body's inflammatory response, which is worthy of promotion. Postoperative recurrence was related to age, tumor diameter, TNM stage, surgical method, and postoperative immunotherapy.

A rare jejunum retroperitoneal hernia case report and literature review

This report describes a rare case of retroperitoneal hernia and its preoperative diagnosis. Contrast-enhanced CT and multiplanar reconstruction were used to observe the hernia ring, hernia tract, contents and blood flow of a retroperitoneal hernia. The diagnosis of and conditions related to the retroperitoneal hernia were confirmed by CT soon after hospitalisation. There are no reports on the diagnosis of primary retroperitoneal hernia on CT in the literature to date, and we share this case to facilitate the accurate and timely identification of small intestine retroperitoneal hernias in the future.