Drain Site Abdominal Hernia: Known but Rare Complication of Abdominal Drains, a Case Report and a Review of Drain Site Complications

Samarawickrama, MB; Senavirathna, R W; Hapuarachchi, Upul

doi:10.9790/3013-0704011014

Cited by 6 publications

(10 citation statements)

References 8 publications

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“…Common complications of placing drains include drain site sepsis, bleeding, migration, kinking and knotting of drains, intestinal obstruction, fistulae or erosion into viscera with peritonitis and herniation. [ 1 2 ] Several case reports are there in the literature, documenting evisceration of multiple organs from larger drain site such as small bowel, omentum, appendix, fallopian tube, ovary and gallbladder,[ 3 4 ] with the most common being small bowel. [ 2 ] Almost all these cases were open surgeries.…”

Section: Discussionmentioning

confidence: 99%

“…Evisceration has been documented with smaller drains (6 mm), suggesting that size is not the only factor despite the fact that most cases were reported in patients with a drain size of 10 mm or more. [ 1 3 6 ] Rather than the size, the nature of tract plays an important role. Usage of port site for drain placement increases the risk of evisceration as they have a straight tract which does not approximate well on deflating pneumoperitoneum unlike a zigzag tract.…”

Section: Discussionmentioning

confidence: 99%

“…Many studies have failed to show the superiority of using drains. [ 1 ] Drain site herniation, evisceration, migration of drain, ascending infection and perforation of a viscus are potential morbidities after drain placement, albeit rare. Drain site evisceration constitutes an emergency with risk of strangulation of the viscus.…”

Section: Introductionmentioning

confidence: 99%

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A case of unusual evisceration through laparoscopic port site

James

Senthil

Kalayarasan

et al. 2021

Journal of Minimal Access Surgery

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Drain site eviscerations have been reported as a rare complication following abdominal surgery. An 82-year-old women was diagnosed with carcinoma stomach and underwent laparoscopic subtotal gastrectomy. A few hours following removal of the duodenal stump drain, she developed small bowel evisceration through the drain site. It was successfully managed with immediate bedside release of fascial constriction followed by definitive repair later. Although herniations and eviscerations via larger drain sites have been reported, eviscerations from small laparoscopic port sites used for drains are rare. Here, we report the first case of small bowel evisceration with strangulation through a 5-mm port site.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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A case of unusual evisceration through laparoscopic port site

James

Senthil

Kalayarasan

et al. 2021

Journal of Minimal Access Surgery

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“…[4][5][6][7] Out of these most common was small bowel loops and appendix. [9][10][11] Omentum was found as a content in very few cases as reported by Bakka et al and Samarawickrama et al 12,13 There are cases in literature found to have drain site hernia with small bowel and omentum as content but none of the case is found to have bilateral drain site hernia.…”

Section: Discussionmentioning

confidence: 99%

A rare case of bilateral drain site abdominal hernia: a case report and review of literature

2020

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Use of abdominal drain is a tradition used since a long time. These is generally done to prevent or drain any post-operative intra-abdominal collection aiming to reduce morbidity and mortality and early recovery of patient. But drain has its own complication such as drain site infection, drain site hernia. We encountered a case of bilateral drain site hernia in a 55 year old female who was previously operated for perforation peritonitis. Both herniae were repaired successfully with onlay meshplasty. Drain placement has various complications like drain site infection, adhesion's, intestinal erosion, bleeding, anastamotic rupture and drain site hernia. There is greater risk of hernia in patient with poor nutritional status, obesity, ascitis, severe abdominal infection or with persistent cough. It is better to avoid unnecessary placement of drain. If a drain is placed, its removal should be done as early as possible. It is better to close the defect after removal of drain.

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“…A particular drain could serve any combination of these purposes. Intra-peritoneal drain placement is however associated with some risks ranging from minor unnoticeable, through life-altering such as infertility, to life-threatening as in the case of visceral evisceration or perforation (3,4,5,6). The benefit of routine drain placement for different varieties of abdominal surgeries has remained a debate in contemporary times (4,5,7,8).…”

Section: Introductionmentioning

confidence: 99%

Pathogenesis of peritoneal drain complications; a case report of evolving adnexal evisceration following difficult retrieval of a retained peritoneal drain

Imaralu¹,

Oguntade²,

Nwankpa³

et al. 2022

Babcock Univ. Med. J.

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Background: Intra-peritoneal drainage dates back to the time of Hippocrates when long bone tissue, metal, and glass tubes were employed. The benefit of routine intra-peritoneal drainage however remains debatable in contemporary times. Retained drains may be outward manifestations of more sinister or latent complications and how an entrapped surgical drain is removed, may determine the occurrence of further complications. Case Presentation: We report here the case of a 32-year-old primipara who had a retained improvised peritoneal drain, which was inserted during the cesarean section for continued oozing of serosanguineous fluid. Omental tissue found at laparoscopy, to have plugged a fenestration in the drain, was promptly relieved. A loop of the Fallopian tube was however later observed trapped in another fenestration and herniating into the stab incision of the drain tube towards the exterior, this was freed with an atraumatic laparoscopic grasper and drain tube retrieval completed under laparoscopic visualization. Conclusion: Insertion of the peritoneal drain during cesarean section should be carefully considered, when necessary; it should be done with the most appropriate drainage systems. Retrieval of the peritoneal drain is a risk factor for visceral herniation. Entrapped drains should be retrieved, under direct visualization, to prevent iatrogenic injuries.

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Drain Site Abdominal Hernia: Known but Rare Complication of Abdominal Drains, a Case Report and a Review of Drain Site Complications

Cited by 6 publications

References 8 publications

A case of unusual evisceration through laparoscopic port site

A case of unusual evisceration through laparoscopic port site

A rare case of bilateral drain site abdominal hernia: a case report and review of literature

Pathogenesis of peritoneal drain complications; a case report of evolving adnexal evisceration following difficult retrieval of a retained peritoneal drain

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